Individual provider Active NPI

Eric R Capps, DDS

  • General Practice Dentistry
  • Virginia Beach, VA
National Provider Identifier
1639338510
Registry record updated Mar 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401006771 Issued in VA
Practice address
836 First Colonial Rd
Virginia Beach, VA 23451-6126
Phone
(757) 428-8747
Fax
(757) 422-8165
NPI assigned
Jun 5, 2008
Last updated
Mar 28, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401006771 VA
General Practice Dentistry 1223G0001X 0401006771 VA Primary

Addresses

Primary practice location

836 First Colonial Rd
Virginia Beach, VA 23451-6126

Mailing address

836 First Colonial Rd
Virginia Beach, VA 23451-6126
Phone (757) 428-8747

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0401006771VAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
CD Virginia Dental, P.C. Dentist CurrentSince Apr 3, 2022 Accepting new patients
Jung S Pak DDS PC Past Accepting new patients

Locations

836 First Colonial Rd
Virginia Beach, VA 23451
Phone (757) 428-8747

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648425600000",
    "number": "1639338510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 FIRST COLONIAL RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234516126",
            "telephone_number": "757-428-8747",
            "fax_number": "757-422-8165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 FIRST COLONIAL RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234516126",
            "telephone_number": "757-428-8747",
            "fax_number": "757-422-8165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPPS",
        "first_name": "ERIC",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-05",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401006771",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401006771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 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.