NPIMap

Organization Active NPI

Smithfield Dental

  • General Practice Dentistry
  • Smithfield, VA
National Provider Identifier
1487910352
Registry record updated Apr 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
VA6344 Issued in VA
Legal business name
SMITHFIELD DENTAL
Practice address
12746 Courthouse Hwy
Smithfield, VA 23430-7117
Phone
(757) 357-6779
Fax
(757) 357-2722
NPI assigned
Apr 5, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2012

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

Authorized official

Name
Lena Fuller
Title
Insurance Manager
Phone
(757) 357-6779

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X VA6344 VA Primary

Addresses

Primary practice location

12746 Courthouse Hwy
Smithfield, VA 23430-7117

Mailing address

12746 Courthouse Hwy
Smithfield, VA 23430-7117
Phone (757) 357-6779

National Provider Directory

National Provider Directory
Tax ID family
A Division of Atlantic Dental Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

12746 Courthouse Hwy
Smithfield, VA 23430
Phone (757) 357-6779

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1333584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333584000000",
    "number": "1487910352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12746 COURTHOUSE HWY",
            "city": "SMITHFIELD",
            "state": "VA",
            "postal_code": "234307117",
            "telephone_number": "757-357-6779",
            "fax_number": "757-357-2722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12746 COURTHOUSE HWY",
            "city": "SMITHFIELD",
            "state": "VA",
            "postal_code": "234307117",
            "telephone_number": "757-357-6779",
            "fax_number": "757-357-2722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMITHFIELD DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-05",
        "last_updated": "2012-04-05",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "LENA",
        "authorized_official_title_or_position": "INSURANCE MANAGER",
        "authorized_official_telephone_number": "757-357-6779"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "VA6344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithfield, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2012; 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.