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Organization Active NPI

Riccobene & Associates Ccii, DDS, PC

Doing business as Commonwealth Specialty - Colonial Heights Peds

  • Pediatric Dentistry
  • Colonial Heights, VA
National Provider Identifier
1699549857
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
RICCOBENE & ASSOCIATES CCII, DDS, PC
Doing business as
Commonwealth Specialty - Colonial Heights Peds
Practice address
456 Charles H Dimmock Pkwy Ste 9
Colonial Heights, VA 23834-2936
Phone
(804) 520-7292
NPI assigned
Nov 8, 2023
Last updated
Aug 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Authorized official

Name
Michael Riccobene
Title
Ceo
Phone
(910) 853-6172

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

456 Charles H Dimmock Pkwy Ste 9
Colonial Heights, VA 23834-2936

Mailing address

PO Box 749632
Atlanta, GA 30374-9632
Phone (804) 520-7292

Other names 1

  • Commonwealth Specialty - Colonial Heights Peds Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Commonwealth Specialty - Charlottesville7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

NPI Registry JSON

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

{
    "created_epoch": "1699401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722556800000",
    "number": "1699549857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749632",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749632",
            "telephone_number": "804-520-7292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 CHARLES H DIMMOCK PKWY STE 9",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238342936",
            "telephone_number": "804-520-7292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICCOBENE & ASSOCIATES CCII, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-08",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A",
        "authorized_official_last_name": "RICCOBENE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-853-6172"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Commonwealth Specialty - Colonial Heights Peds",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Commonwealth Specialty - Colonial Heights Peds",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Colonial Heights, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; 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.