Dentrust Dental Virginia, P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DENTRUST DENTAL VIRGINIA, P.C.

Doing business as

DOCS Ft. Belvoir

Practice address

8651 John J Kingman Rd BLDG 2321
Ft Belvoir, VA 22060-6200

Phone

(267) 927-5000

NPI assigned

Aug 10, 2021

Organization subpart

Yes

Parent organization

DENTRUST DENTAL VIRGINIA PCAs reported in NPPES

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

Authorized official

Name

Amanda Anne Clark

Title

Director of Credentialing

Phone

(267) 927-5000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• DOCS Ft. Belvoir Doing business as

Electronic endpoints 1

Tax ID family

Dentrust Dental Virginia PC2 organizations share this tax ID, including this one

Part of

Dentrust Dental Virginia PC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Dentrust Dental Virginia, P.C.

  • Dentist
  • Pipersville, PA
  • NPI 1356804983
  NPD tax ID

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

{
    "created_epoch": "1628553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628553600000",
    "number": "1679248926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 VINEWOOD DR",
            "city": "SEFFNER",
            "state": "FL",
            "postal_code": "335844829",
            "telephone_number": "813-451-4503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8651 JOHN J KINGMAN RD BLDG 2321",
            "city": "FT BELVOIR",
            "state": "VA",
            "postal_code": "220606200",
            "telephone_number": "267-927-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTRUST DENTAL VIRGINIA, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTRUST DENTAL VIRGINIA PC",
        "enumeration_date": "2021-08-10",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "DIRECTOR OF CREDENTIALING",
        "authorized_official_telephone_number": "267-927-5000"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR.CAPLINS VA LIC",
            "identifier": "0401412009",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ft.belvoirinfo@docs.health",
            "affiliation": "N",
            "address_1": "8651 John J Kingman Rd Bldg 2321",
            "city": "Ft Belvoir",
            "state": "VA",
            "country_code": "US",
            "postal_code": "220606200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "DOCS Ft. Belvoir",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jesse Deluca, D.O.
• Sally Phelan Delvecchio, D.O.
• Michele Denker, MD
• David Houston Dennison, M.D.
• Sheri K Dennison, MD
• Gary A Derosa, M.D.
• Franchesca Moreau Desriviere, CNM
• Dewitt Army Community Hospital
• Dewitt Army Community Hospital
• Dewitt Army Community Hospital

• General Practice Dentistry in Ft Belvoir, VA
• Providers in Ft Belvoir, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2021; 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.