Stephen C Booth, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401411024 Issued in VA

Practice address

5954 Harbour Park Dr
Midlothian, VA 23112-2163

Phone

(804) 739-1600

Fax

(804) 739-9035

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in VA

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Robert N Penterson DDS PC

  • General Practice Dentistry
  • Midlothian, VA
  • NPI 1265983506
  NPD Authorized official
• Robert N. Penterson, DDS, PC

  • General Practice Dentistry
  • Midlothian, VA
  • NPI 1891905923
  NPD Authorized official
• Amanda a. Hoover Dental PC

  • General Practice Dentistry
  • Midlothian, VA
  • NPI 1467103200
  NPD

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404000000000",
    "number": "1457445314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5954 HARBOUR PARK DR",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231122163",
            "telephone_number": "804-739-1600",
            "fax_number": "804-739-9035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5954 HARBOUR PARK DR",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231122163",
            "telephone_number": "804-739-1600",
            "fax_number": "804-739-9035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "STEPHEN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2014-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401411024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL PROVIDER NO.",
            "identifier": "11024",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NO.",
            "identifier": "182419",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9179964",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kyle Bond, DDS
• Rita Arvindbhai Bond, PHARMD
• Natalie Salera Bondy, LPC
• Kimberly Boone, LCSW
• Catherine Lynn Penterson Booth, D.D.S.
• Lisa Borchert, MS, CCC-A
• Bryce Bossin, PT
• Kaitlin Elizabeth Bountress, PHD
• Katharine Blair Bowers, M.D.
• Joshua D Bowling, M.D.

• General Practice Dentistry in Midlothian, VA
• Providers in Midlothian, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.