Chesapeake Family Dental

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

CHESAPEAKE FAMILY DENTAL

Practice address

113 Gainsborough SQ
Suite 101
Chesapeake, VA 23320-1713

Phone

(757) 548-5619

Fax

(757) 548-6930

NPI assigned

Oct 30, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Osama S Modjadidi, DMD

Title

Owner

Phone

(757) 548-5619

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1351555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351555200000",
    "number": "1629322615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 GAINSBOROUGH SQ",
            "address_2": "SUITE 101",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233201713",
            "fax_number": "757-548-6930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 GAINSBOROUGH SQ",
            "address_2": "SUITE 101",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233201713",
            "telephone_number": "757-548-5619",
            "fax_number": "757-548-6930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESAPEAKE FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-30",
        "last_updated": "2012-10-30",
        "status": "A",
        "authorized_official_last_name": "MODJADIDI",
        "authorized_official_first_name": "OSAMA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-548-5619",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chesapeake Diagnostic Imaging Centers, LLC
• Chesapeake Ear, Nose & Throat Associates, P.C.
• Chesapeake Eye Physicians Optical
• Chesapeake Eye Physicians, PLC
• Chesapeake Family and Implant Dentistry LLC
• Chesapeake Family Practice, PC
• Chesapeake Foot and Ankle Center PC
• Chesapeake Health Investment Program, Inc
• Chesapeake Hearing AIDS LLC
• Chesapeake Hospital Authority

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2012; 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.