Active NPI
MB. Dental Care PLLC
- Dentist
- Bristow, VA
National Provider Identifier
1407456353
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- Legal business name
- MB. DENTAL CARE PLLC
- Practice address
- 12701 Braemar Village PLZ
Bristow, VA 20136-5501 - Phone
- (703) 589-7040
- NPI assigned
- Oct 29, 2020
- Organization subpart
- Yes
- Parent organization
- MB, DENTAL CARE PLLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tamesha Morris
- Title
- Ceo
- Phone
- (804) 690-3005
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | Primary |
Addresses
Primary practice location
12701 Braemar Village PLZ
Bristow, VA 20136-5501
Mailing address
14609 Brindle Creek Road
Woodbridge, VA 22193
Phone (703) 589-7040
National Provider Directory
National Provider Directory- Part of
- MB Dental Care PLLC
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- General Practice Dentistry
- Dumfries, VA
- NPI 1073708905
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603929600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1607040000000",
"number": "1407456353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14609 BRINDLE CREEK ROAD",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "22193",
"telephone_number": "703-589-7040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12701 BRAEMAR VILLAGE PLZ",
"city": "BRISTOW",
"state": "VA",
"postal_code": "201365501",
"telephone_number": "703-589-7040"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MB. DENTAL CARE PLLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "MB, DENTAL CARE PLLC",
"enumeration_date": "2020-10-29",
"last_updated": "2020-12-04",
"certification_date": "2020-12-04",
"status": "A",
"authorized_official_last_name": "MORRIS",
"authorized_official_first_name": "TAMESHA",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "804-690-3005"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bristow, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.