NPIMap

Organization Active NPI

Hampton Roads Pediatric Dentistry and Orthodontics, PLLC

Doing business as Yorktown Pediatric Dentistry

  • Pediatric Dentistry
  • Yorktown, VA
National Provider Identifier
1689047839
Registry record updated Apr 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
0401410912 Issued in VA
Legal business name
HAMPTON ROADS PEDIATRIC DENTISTRY AND ORTHODONTICS, PLLC
Doing business as
Yorktown Pediatric Dentistry
Practice address
7109 George Washington Mem Hwy
Yorktown, VA 23692-4842
Phone
(757) 598-2097
NPI assigned
Nov 10, 2015
Last updated
Apr 12, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
HAMPTON ROADS PEDIATRIC DENTISTRY AND ORTHODONTICS, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 12, 2019

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

Authorized official

Name
Grace O Davis
Title
Business Administrator
Phone
(757) 369-1754

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 0401410912 VA Primary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 0401412905 VA

Addresses

Primary practice location

7109 George Washington Mem Hwy
Yorktown, VA 23692-4842

Mailing address

3120 Kiln Creek Pkwy Ste P
Yorktown, VA 23693-5648
Phone (757) 369-1754

Other names 1

  • Yorktown Pediatric Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Hampton Roads Pediatric Dentistry and Orthodontics PLLC5 organizations share this tax ID, including this one
Part of
Hampton Roads Pediatric Dentistry and Orthodontics PLLC

Other organizations with this tax ID 4

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1447113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555027200000",
    "number": "1689047839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3120 KILN CREEK PKWY STE P",
            "city": "YORKTOWN",
            "state": "VA",
            "postal_code": "236935648",
            "telephone_number": "757-369-1754",
            "fax_number": "757-234-8891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7109 GEORGE WASHINGTON MEM HWY",
            "city": "YORKTOWN",
            "state": "VA",
            "postal_code": "236924842",
            "telephone_number": "757-598-2097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAMPTON ROADS PEDIATRIC DENTISTRY AND ORTHODONTICS, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HAMPTON ROADS PEDIATRIC DENTISTRY AND ORTHODONTICS, PLLC",
        "enumeration_date": "2015-11-10",
        "last_updated": "2019-04-12",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "GRACE",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "BUSINESS ADMINISTRATOR",
        "authorized_official_telephone_number": "757-369-1754"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "VA",
            "license": "0401410912",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "VA",
            "license": "0401412905",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Yorktown Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yorktown, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2019; 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.