Commonwealth Pediatric Dental Specialists

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

401411512 Issued in VA

Legal business name

COMMONWEALTH PEDIATRIC DENTAL SPECIALISTS

Practice address

5506 Whiteside Road
Sandston, VA 23150-2345

Phone

(617) 875-6808

NPI assigned

Oct 31, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Joy Phelps, D.M.D.NPI 1588864045

Title

Pediatric Dentist/Owner

Phone

(617) 875-6808

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joy Phelps, D.M.D.

  • Pediatric Dentistry
  • Sandston, VA
  • NPI 1588864045
  NPD (past) Authorized official

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

{
    "created_epoch": "1414713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414713600000",
    "number": "1679978795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5506 WHITESIDE ROAD",
            "city": "SANDSTON",
            "state": "VA",
            "postal_code": "231502345",
            "telephone_number": "617-875-6808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5506 WHITESIDE ROAD",
            "city": "SANDSTON",
            "state": "VA",
            "postal_code": "231502345",
            "telephone_number": "617-875-6808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH PEDIATRIC DENTAL SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-31",
        "last_updated": "2014-10-31",
        "status": "A",
        "authorized_official_last_name": "PHELPS",
        "authorized_official_first_name": "JOY",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST/OWNER",
        "authorized_official_telephone_number": "617-875-6808",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "VA",
            "license": "401411512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jahquail Conyers, LABA
• Cooke Richardson & Overstreet DDS PC

• Dental Clinic/Center in Sandston, VA
• Providers in Sandston, VA by specialty
• Dental Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2014; 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.