David B Pemberton DDS PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401005552 Issued in VA

Legal business name

DAVID B PEMBERTON DDS PC

Practice address

101 Cowardin Avenue
Suite 303
Richmond, VA 23224

Phone

(804) 233-6811

Fax

(804) 230-0980

NPI assigned

Jul 20, 2006

Organization subpart

No

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

Authorized official

Name

Dr. David B Pemberton, DDSNPI 1073704219

Title

Doctor of Dental Surgery

Phone

(804) 233-6811

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

Practitioners 1

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

• David Brent Pemberton, D.D.S.

  • General Practice Dentistry
  • Richmond, VA
  • NPI 1073704219
  NPD (past) Authorized official

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283385600000",
    "number": "1629098199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 COWARDIN AVENUE",
            "address_2": "SUITE 303",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "23224",
            "telephone_number": "804-233-6811",
            "fax_number": "804-230-0980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 COWARDIN AVENUE",
            "address_2": "SUITE 303",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "23224",
            "telephone_number": "804-233-6811",
            "fax_number": "804-230-0980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID B PEMBERTON DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2010-09-02",
        "status": "A",
        "authorized_official_last_name": "PEMBERTON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "DOCTOR OF DENTAL SURGERY",
        "authorized_official_telephone_number": "804-233-6811",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401005552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "077681",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "00762638",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "172260",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7815042",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dana Antoine Davenport
• Michelle Davenport, R.N.
• Nathan J Davenport, ANP-C
• Taylor Davenport
• Allen James Davia, DDS
• David C Circeo, DDS PC
• David C. Circeo D.D.S., P.C.
• David Herzka
• David Hoover Consulting LLC
• David Johnston, O.D.

• General Practice Dentistry in Richmond, VA
• Providers in Richmond, 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 Sep 2, 2010; 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.