Gardiner McKay Packer, D.D.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

0401412190 Issued in VA

Practice address

6037 Harbour Park Dr
Midlothian, VA 23112-2160

Phone

(804) 744-3636

Fax

(804) 744-6365

NPI assigned

Sep 4, 2007

Last updated

Jun 23, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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

Practice roles

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

• Bruce W. Overton DDS PC

  dba Dominion Endodontics

  • Endodontics
  • Midlothian, VA
  • NPI 1609006865
  NPD (past)

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

{
    "created_epoch": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245715200000",
    "number": "1720272768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5333 WHETSTONE RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232344325",
            "telephone_number": "804-743-7023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6037 HARBOUR PARK DR",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231122160",
            "telephone_number": "804-744-3636",
            "fax_number": "804-744-6365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACKER",
        "first_name": "GARDINER",
        "middle_name": "MCKAY",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-04",
        "last_updated": "2009-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "VA",
            "license": "0401412190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oxbridge Counseling Services, PC
• Dellwynn Oxendine
• Rebecca B Ozmore, M.ED., LPC
• Betty Blanton Pace, RPH
• Lupe Barbara Pacheco, P.A.
• Thomas B Padgett, DMD
• Shelby Paez, OTR/L
• Ellen Marye Palen, M.D.
• Christopher E Paoloni, MD
• Unni Ligin Ligin Papachan

• Endodontics in Midlothian, VA
• Providers in Midlothian, VA by specialty
• Endodontics in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2009; 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.