Jessaca Shonte Charite, DMD, MPH

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

0401417367 Issued in VA

Practice address

3716 Melrose Ave NW
Roanoke, VA 24017-2716

Phone

(540) 362-0360

NPI assigned

May 21, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jessica.charite.p1@direct.jordanvalley.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Positiviteeth PLLC

  • Dental Clinic/Center
  • Salem, VA
  • NPI 1356097463
  NPD Authorized official

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

{
    "created_epoch": "1558396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1710544176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3716 MELROSE AVE NW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240172716",
            "telephone_number": "540-362-0360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3716 MELROSE AVE NW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240172716",
            "telephone_number": "540-362-0360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARITE",
        "first_name": "JESSACA",
        "middle_name": "SHONTE",
        "name_prefix": "Dr.",
        "credential": "DMD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-21",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "VA",
            "license": "0401417367",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Change Up Behavioral Services, LLC.
• Kristina Chanthavixay
• Caroline Cross Chapman
• Moriah M. Chapman, MS, CCC/SLP
• Trevar Chapmon, M.D.
• Sada Charlemagne-Brown
• Charlottesville League of Therapists
• Charlottesville League of Therapists, Inc (Roanoke League of Therapists)
• Angela Karen Charlton, RD, CNSD
• Megan Rianne Charr

• Pediatric Dentistry in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Pediatric Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.