NPIMap

Organization Active NPI

Dominion Dermatology PC

  • Dermatology Physician
  • Glen Allen, VA
National Provider Identifier
1366642852
Registry record updated Oct 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
101041436 Issued in VA
Legal business name
DOMINION DERMATOLOGY PC
Practice address
5201 Hickory Park Dr
Suite a
Glen Allen, VA 23059-2623
Phone
(804) 262-6060
NPI assigned
Jul 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Sharon S Camden, MD
Title
Owner
Phone
(804) 262-6060

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 101041436 VA Primary

Addresses

Primary practice location

5201 Hickory Park Dr
Suite a
Glen Allen, VA 23059-2623

Mailing address

5201 Hickory Park Dr
Suite a
Glen Allen, VA 23059-2623
Phone (804) 262-6060

National Provider Directory

National Provider Directory

Locations

5201 Hickory Park Dr
Ste A
Glen Allen, VA 23059
Phone (804) 262-6060

8604 Staples Mill Rd
Richmond, VA 23228
Phone (804) 262-6060

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319155200000",
    "number": "1366642852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5201 HICKORY PARK DR",
            "address_2": "SUITE A",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230592623",
            "telephone_number": "804-262-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 HICKORY PARK DR",
            "address_2": "SUITE A",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230592623",
            "telephone_number": "804-262-6060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOMINION DERMATOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-23",
        "last_updated": "2011-10-21",
        "status": "A",
        "authorized_official_last_name": "CAMDEN",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "804-262-6060",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "VA",
            "license": "101041436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Allen, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.