Individual provider Active NPI

Cadette Lancy Deneville, DDS

  • Dentist
  • Danville, VA
National Provider Identifier
1639911654
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401419013 Issued in VA
Practice address
501 Rison St Ste 110
Danville, VA 24541-2426
Phone
(786) 488-0428
NPI assigned
Jun 10, 2024
Last updated
Jun 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401419013 VA Primary

Addresses

Primary practice location

501 Rison St Ste 110
Danville, VA 24541-2426

Mailing address

501 Rison St Ste 110
Danville, VA 24541-2426
Phone (786) 488-0428

Other identifiers 1

IdentifierTypeStateIssuer
0401419013OtherVAVA LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240814000152 VA Order and Referring Only - DentistPractitioner - Dentist 4486192044

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0401419013VAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1717977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1639911654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 RISON ST STE 110",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245412426",
            "telephone_number": "786-488-0428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 RISON ST STE 110",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245412426",
            "telephone_number": "786-488-0428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENEVILLE",
        "first_name": "CADETTE",
        "middle_name": "LANCY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-10",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401419013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA LICENSE NUMBER",
            "identifier": "0401419013",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, VA

Sources for this page

Verify at the official NPI Registry.