NPIMap

Organization Active NPI

Neibauer Dental Care, PC

Doing business as Neibauer Dental Care - Centreville

  • General Practice Dentistry
  • Centreville, VA
National Provider Identifier
1730448010
Registry record updated May 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401411903 Issued in VA
Legal business name
NEIBAUER DENTAL CARE, PC
Doing business as
Neibauer Dental Care - Centreville
Practice address
5742 Pickwick Rd Ste 15
Centreville, VA 20121-4730
Phone
(703) 688-2056
NPI assigned
May 8, 2012
Last updated
May 8, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
NEIBAUER DENTAL CARE, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 8, 2012

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

Authorized official

Name
Kelli Walker
Title
Insurance/Credentialing
Phone
(217) 540-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0401411903 VA Primary

Addresses

Primary practice location

5742 Pickwick Rd Ste 15
Centreville, VA 20121-4730

Mailing address

5742 Pickwick Rd Ste 15
Centreville, VA 20121-4730
Phone (703) 688-2056

Other names 1

  • Neibauer Dental Care - Centreville Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Neibauer Dental Care PC30 organizations share this tax ID, including this one
Part of
Neibauer Dental Care PC

Other organizations with this tax ID 29

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

View all 29

Locations

5742 Pickwick Rd
Ste 15
Centreville, VA 20121
Phone (703) 688-2056

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1336435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336435200000",
    "number": "1730448010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5742 PICKWICK RD STE 15",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201214730",
            "telephone_number": "703-688-2056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5742 PICKWICK RD STE 15",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201214730",
            "telephone_number": "703-688-2056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEIBAUER DENTAL CARE, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEIBAUER DENTAL CARE, PC",
        "enumeration_date": "2012-05-08",
        "last_updated": "2012-05-08",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "KELLI",
        "authorized_official_title_or_position": "INSURANCE/CREDENTIALING",
        "authorized_official_telephone_number": "217-540-5100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401411903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Neibauer Dental Care - Centreville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Centreville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2012; 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.