Petersburg Family Dental PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PETERSBURG FAMILY DENTAL PLLC

Doing business as

Terry Family Dentistry

Practice address

21312 Chesterfield Ave
South Chesterfield, VA 23803-2406

Phone

(804) 615-9682

NPI assigned

Nov 1, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Jim Ervil, DDS

Title

Dentist

Phone

(804) 615-9682

Specialties & licenses 1

Addresses

Other names 1

• Terry Family Dentistry Doing business as

Locations

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

{
    "created_epoch": "1698796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698796800000",
    "number": "1558134650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21312 CHESTERFIELD AVE",
            "city": "SOUTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "238032406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21312 CHESTERFIELD AVE",
            "city": "SOUTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "238032406",
            "telephone_number": "804-615-9682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERSBURG FAMILY DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-01",
        "last_updated": "2023-11-01",
        "certification_date": "2023-10-17",
        "status": "A",
        "authorized_official_last_name": "ERVIL",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "804-615-9682",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Terry Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Opulent Springs Resources
• Gerald Ott
• Peaceful Guidance Youth Services
• Peaceful Wellness PLLC
• Pebble Creek Homes
• Tamesha Michelle Pettiford, MSW
• Mary Phillips
• Shamonda Phillips
• David Charles Pierce Jr.
• Pink Lotus Therapeutic Counseling

• General Practice Dentistry in South Chesterfield, VA
• Providers in South Chesterfield, 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 Nov 1, 2023; 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.