Antonio Mauri, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

0401414502 Issued in VA

Practice address

14001 Charter Park Drive
Midlothian, VA 23114

Phone

(804) 379-1011

Fax

(804) 419-1059

NPI assigned

Apr 28, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Sep 23, 2016 through Sep 23, 2026

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Virginia Family Dentistry PC

  • General Practice Dentistry
  • Midlothian, VA
  • NPI 1750435970
  NPD (past)

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

{
    "created_epoch": "1398643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1548670789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1612 HUGUENOT RD",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "23113",
            "telephone_number": "804-794-9789",
            "fax_number": "804-419-1059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14001 CHARTER PARK DRIVE",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "23114",
            "telephone_number": "804-379-1011",
            "fax_number": "804-419-1059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAURI",
        "first_name": "ANTONIO",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-28",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401414502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Owen Mattes, D.P.T.
• Matthew W Stafford DDS, PC
• Keith Anthony Matthews
• Sandra Mattos
• Genevieve R. Matulin, MSN, NP-C
• Kayla May
• Kendall L Mayfield, LCSW
• Robert E. Mayfield, MD
• Dianne Carter Mays
• Dustin Ryan Mays, OTR

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.