Timothy Michael Breeden, DDS
Individual provider Active NPI Dentist · Chesterfield, VA
NPI 1487764668 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1487764668
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 0401410255 (VA)
- Practice address
- 10003 Court View Lane
Chesterfield, VA 23832 - Phone
- (804) 748-6433
- Fax
- (804) 796-2713
- NPI assigned
- Aug 30, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401410255 | VA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Commonwealth Dental Sleep Medicine Inc | Current |
Accepting new patients |
Locations
10601 Greenyard Way
Chester, VA 23831
Phone (804) 748-6433
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 0401410255 | VA | Yes |
Addresses
Primary practice location
10003 Court View Lane
Chesterfield, VA 23832
Mailing address
10003 Court View Lane
Chesterfield, VA 23832
Phone (804) 748-6433
Other providers in Chesterfield, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.