NPIMap

Organization Active NPI

Riccobene & Associates Ccii, DDS, PC

  • Periodontics
  • Suffolk, VA
National Provider Identifier
1467226720
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
Legal business name
RICCOBENE & ASSOCIATES CCII, DDS, PC
Doing business as
Commonwealth Specialty - Suffolk
Practice address
2003 Meade Pkwy
Suffolk, VA 23434-4259
Phone
(757) 514-3656
NPI assigned
Nov 8, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Authorized official

Name
Michael Riccobene
Title
Ceo
Phone
(910) 853-6172

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X Primary

Addresses

Primary practice location

2003 Meade Pkwy
Suffolk, VA 23434-4259

Mailing address

PO Box 749632
Atlanta, GA 30374-9632
Phone (757) 514-3656

Other names 1

  • Commonwealth Specialty - Suffolk Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Commonwealth Specialty - Charlottesville7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1699401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722556800000",
    "number": "1467226720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749632",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749632",
            "telephone_number": "757-514-3656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 MEADE PKWY",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234344259",
            "telephone_number": "757-514-3656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICCOBENE & ASSOCIATES CCII, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-08",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A",
        "authorized_official_last_name": "RICCOBENE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-853-6172"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Commonwealth Specialty - Suffolk",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Commonwealth Specialty - Suffolk",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Suffolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; 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.