NPIMap

Organization Active NPI

Crozet Pediatric Dentistry, PC

  • Pediatric Dentistry
  • Crozet, VA
National Provider Identifier
1447699277
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
0401411881 Issued in VA
Legal business name
CROZET PEDIATRIC DENTISTRY, PC
Practice address
300 Claremont Lane
Suite 101
Crozet, VA 22932-3369
Phone
(434) 205-4594
Fax
(434) 205-4627
NPI assigned
Jun 14, 2013
Last updated
Apr 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

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

Authorized official

Name
Dr. Kevin Clifford, DDSNPI 1770788069
Title
President/Pediatric Dentist
Phone
(804) 387-2423

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)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 0401411881 VA Primary

Addresses

Primary practice location

300 Claremont Lane
Suite 101
Crozet, VA 22932-3369

Mailing address

1005 Heathercroft Cir Ste 300
Crozet, VA 22932-3369

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Office

National Provider Directory

National Provider Directory

Locations

1005 Heathercroft Cir
Ste 300
Crozet, VA 22932

300 Claremont Ln
Ste 101
Crozet, VA 22932
Phone (434) 205-4594

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1371168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650412800000",
    "number": "1447699277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 HEATHERCROFT CIR STE 300",
            "city": "CROZET",
            "state": "VA",
            "postal_code": "229323369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CLAREMONT LANE",
            "address_2": "SUITE 101",
            "city": "CROZET",
            "state": "VA",
            "postal_code": "229323369",
            "telephone_number": "434-205-4594",
            "fax_number": "434-205-4627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROZET PEDIATRIC DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-14",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-06",
        "status": "A",
        "authorized_official_last_name": "CLIFFORD",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "PRESIDENT/PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "804-387-2423",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "VA",
            "license": "0401411881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Office",
            "affiliation": "N",
            "address_1": "300 Claremont Lane",
            "address_2": "Suite 101",
            "city": "Crozet",
            "state": "VA",
            "country_code": "US",
            "postal_code": "229323369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Crozet, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2022; 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.