Individual provider Active NPI

Joseph Niamtu III, D.M.D

  • Oral and Maxillofacial Surgery (Dentist)
  • Midlothian, VA
National Provider Identifier
1427019405
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
1401006101 Issued in VA
Practice address
11319 Polo PL
Midlothian, VA 23113-1434
Phone
(804) 794-0794
Fax
(804) 379-2858
NPI assigned
Mar 30, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 1401006101 VA Primary

Addresses

Primary practice location

11319 Polo PL
Midlothian, VA 23113-1434

Mailing address

11545-A Nuckols Road
Glen Allen, VA 23059
Phone (804) 673-8061

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Nov 10, 2023 through Nov 10, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1401006101VAMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Niamtu & Alexander Oral & Maxillofacial Surgery PC Oral and Maxillofacial Surgery PastSince Sep 1, 2019 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427019405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11545-A NUCKOLS ROAD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "23059",
            "telephone_number": "804-673-8061",
            "fax_number": "804-673-5644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11319 POLO PL",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231131434",
            "telephone_number": "804-794-0794",
            "fax_number": "804-379-2858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIAMTU",
        "first_name": "JOSEPH",
        "name_suffix": "III",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "VA",
            "license": "1401006101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, VA

Sources for this page

Verify at the official NPI Registry.