Gabrielle Katherine Nelson

Primary specialty

DentistTaxonomy code 122300000X

License

0401419481 Issued in VA

Practice address

4710 Puddledock Rd Ste 200
Prince George, VA 23875-1269

Phone

(804) 526-4822

NPI assigned

Jun 4, 2025

Sex

Female

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 Jun 27, 2025 through Jun 27, 2027

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 and National Provider Directory roles.

• 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": "1748995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748995200000",
    "number": "1578457735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5108 BROMLEY LN",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232261535",
            "telephone_number": "443-944-7140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4710 PUDDLEDOCK RD STE 200",
            "city": "PRINCE GEORGE",
            "state": "VA",
            "postal_code": "238751269",
            "telephone_number": "804-526-4822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "GABRIELLE",
        "middle_name": "KATHERINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-04",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401419481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebekah Sykes Moss
• Kulsoom T. Murtaza, OD
• My Father'S House,LLC
• Shobha Rani Nalluri, MD
• Skyler Colleen Naves
• Neuro Care of Virginia PC
• Jacob Lloyd Nixon
• Olivia Novak, OD
• Fafa Isabel Nyirenda
• Christopher W Ogburn, MD

• Dentist in Prince George, VA
• Providers in Prince George, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2025; 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.