Amanda Dickerson Collie, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

0401417563 Issued in VA

Practice address

1000 E Broad St Ste 200
Richmond, VA 23219-1930

Phone

(804) 828-9095

NPI assigned

Jun 14, 2021

Last updated

Aug 9, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1629646096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 LIBBIE MILL EAST BLVD APT 508",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232302146",
            "telephone_number": "804-955-9068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E BROAD ST STE 200",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232191930",
            "telephone_number": "804-828-9095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLIE",
        "first_name": "AMANDA",
        "middle_name": "DICKERSON",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-14",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401417563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Farish Colhoun, M.D.
• Collaborative Care Psychiatry, LLC
• Mackenzie Lake Colleton, DPT
• John Christian Colletti, PSYD
• Amelia Holder Colley, M.D.
• Christopher James Collie, D.D.S.
• Carl Hampden Collier, LPC
• Hunter Collier, BCABA, LABA
• Susanne M Colligon, NP
• Constance K Collins Davis

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2022; 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.