NPIMap

Organization Active NPI

Madison County Dental Clinic

  • Public Health or Welfare Agency
  • Madison, VA
National Provider Identifier
1720151582
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
MADISON COUNTY DENTAL CLINIC
Practice address
410 North Main Street
Madison, VA 22727
Phone
(540) 948-5481
Fax
(540) 948-3841
NPI assigned
Nov 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Thomas Johnson, DDS
Title
Public Health Dentist
Phone
(540) 347-6400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X Primary

Addresses

Primary practice location

410 North Main Street
Madison, VA 22727

Mailing address

PO Box 67
410 North Main Street
Madison, VA 22727
Phone (540) 948-5481

Other identifiers 1

IdentifierTypeStateIssuer
4975707MedicaidVA

National Provider Directory

National Provider Directory
Tax ID family
Commonwealth of VA State163 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720151582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 67",
            "address_2": "410 NORTH MAIN STREET",
            "city": "MADISON",
            "state": "VA",
            "postal_code": "22727",
            "telephone_number": "540-948-5481",
            "fax_number": "540-948-3841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 NORTH MAIN STREET",
            "city": "MADISON",
            "state": "VA",
            "postal_code": "22727",
            "telephone_number": "540-948-5481",
            "fax_number": "540-948-3841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON COUNTY DENTAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "PUBLIC HEALTH DENTIST",
        "authorized_official_telephone_number": "540-347-6400",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4975707",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.