Active NPI
Cadette Lancy Deneville, DDS
- Dentist
- Danville, VA
National Provider Identifier
1639911654
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 0401419013
- Practice address
- 501 Rison St Ste 110
Danville, VA 24541-2426 - Phone
- (786) 488-0428
- NPI assigned
- Jun 10, 2024
- Last updated
- Jun 10, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0401419013 | Other | VA | VA 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240814000152 | VA | Order and Referring Only - Dentist | 4486192044 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401419013 | VA | MD | Dentist |
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.