ABA Edzieba Mills-Robertson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

0401413268 Issued in VA

Practice address

1685 K-V Road
Victoria, VA 23974

Phone

(434) 696-4180

Fax

(434) 696-4182

NPI assigned

Sep 7, 2011

Sex

Female

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 1

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

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.

• Blue Ridge Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Arrington, VA
  • NPI 1518945187
  NPD (past)
• Blue Ridge Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Arrington, VA
  • NPI 1962753145
  NPD (past)

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

{
    "created_epoch": "1315353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391731200000",
    "number": "1467733253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70",
            "city": "VICTORIA",
            "state": "VA",
            "postal_code": "239740070",
            "telephone_number": "434-696-2165",
            "fax_number": "434-696-1557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1685 K-V ROAD",
            "city": "VICTORIA",
            "state": "VA",
            "postal_code": "23974",
            "telephone_number": "434-696-4180",
            "fax_number": "434-696-4182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLS-ROBERTSON",
        "first_name": "ABA",
        "middle_name": "EDZIEBA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-07",
        "last_updated": "2014-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401413268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1467733253",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristin Noel Jones, FNP-BC
• Crystal King
• Katrina King
• Elizabeth White Lipp, BCBA, LBA
• Nicolette McKnight
• Paul Chukwugozi Ohai, MD
• Pamela Owens
• Nellie Parrish, LCSW
• Amy Parsons, LPC
• Ashley Pollard, DDS

• Dentist in Victoria, VA
• Providers in Victoria, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 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.