Individual provider Active NPI

Renee Ava McCoy-Collins, D.D.S

  • Oral and Maxillofacial Surgery (Dentist)
  • Washington, DC
National Provider Identifier
1679692214
Registry record updated Jun 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DEN3652 Issued in DC
Practice address
2737 Devonshire PL NW Ste a
Washington, DC 20008-3479
Phone
(202) 232-1116
Fax
(202) 232-1911
NPI assigned
Mar 28, 2007
Last updated
Jun 26, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DEN3652 DC Primary

Addresses

Primary practice location

2737 Devonshire PL NW Ste a
Washington, DC 20008-3479

Mailing address

4708 Blagden Ter NW
Washington, DC 20011-3720
Phone (202) 232-1116

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
DEN3652DCMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Capitol Health Management Services, LLC PastSince Oct 1, 2007 Accepting new patients
Capitol Clinical Dental Services, PLLC Oral and Maxillofacial Surgery Past Accepting new patients

Organizations & group practices 3

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": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372204800000",
    "number": "1679692214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4708 BLAGDEN TER NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200113720",
            "telephone_number": "202-232-1116",
            "fax_number": "202-232-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2737 DEVONSHIRE PL NW STE A",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200083479",
            "telephone_number": "202-232-1116",
            "fax_number": "202-232-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOY-COLLINS",
        "first_name": "RENEE",
        "middle_name": "AVA",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2013-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "DC",
            "license": "DEN3652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2013; 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.