Vivadent PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

VIVADENT PLLC

Practice address

15521 Real Estate Ave Ste 200
King George, VA 22485-5328

Phone

(540) 663-3139

Fax

(540) 301-2260

NPI assigned

Jan 19, 2026

Organization subpart

No

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

Authorized official

Name

Wendy Tavara

Title

Office Manager

Phone

(540) 663-3139

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Hana Tag Elsir Hamza Mohamed, BDS

  • General Practice Dentistry
  • Culpeper, VA
  • NPI 1861179947
  NPD

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

{
    "created_epoch": "1768780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768780800000",
    "number": "1528927233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15521 REAL ESTATE AVE STE 200",
            "city": "KING GEORGE",
            "state": "VA",
            "postal_code": "224855328",
            "telephone_number": "540-663-3139",
            "fax_number": "540-301-2260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15521 REAL ESTATE AVE STE 200",
            "city": "KING GEORGE",
            "state": "VA",
            "postal_code": "224855328",
            "telephone_number": "540-663-3139",
            "fax_number": "540-301-2260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIVADENT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-19",
        "last_updated": "2026-01-19",
        "certification_date": "2026-01-19",
        "status": "A",
        "authorized_official_last_name": "TAVARA",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "540-663-3139"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• US Coast Guard Medical
• Jonnae Usher, ATC
• Shreenath Varadarajan
• Virginia CVS Pharmacy, L.L.C. (CVS Pharmacy # 00392)
• Vital Health & Integrative Care
• Wal-Mart Stores East LP (Vision Center 30-5779)
• Wal-Mart Stores East LP (WalMart Pharmacy 10-5779)
• Waves Clinical Services, PLLC
• Inez Weekes, DPM
• Bridgette Nicole Weeks

• General Practice Dentistry in King George, VA
• Providers in King George, 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 Jan 19, 2026; 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.