Organization Active NPI

Fredericksburg Endodontics PLLC

  • Endodontics
  • Fredericksburg, VA
National Provider Identifier
1720950835
Registry record updated Sep 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
FREDERICKSBURG ENDODONTICS PLLC
Practice address
10039 Patriot Hwy
Fredericksburg, VA 22407-9418
Phone
(540) 225-1605
NPI assigned
Sep 18, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2025

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

Authorized official

Name
Chad Hendricks
Title
Credentialing
Phone
(612) 859-0444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X Primary

Addresses

Primary practice location

10039 Patriot Hwy
Fredericksburg, VA 22407-9418

Mailing address

10039 Patriot Hwy
Fredericksburg, VA 22407-9418
Phone (540) 225-1605

National Provider Directory

National Provider Directory

Locations

10039 Patriot Hwy
Fredericksburg, VA 22407
Phone (540) 225-1605

NPI Registry JSON

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

{
    "created_epoch": "1758153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758153600000",
    "number": "1720950835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10039 PATRIOT HWY",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224079418",
            "telephone_number": "540-225-1605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10039 PATRIOT HWY",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224079418",
            "telephone_number": "540-225-1605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDERICKSBURG ENDODONTICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-18",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A",
        "authorized_official_last_name": "HENDRICKS",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "612-859-0444"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; 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.