Janna Laverdiere, DMD
Individual provider Active NPI Dentist · Madison Heights, VA
NPI 1730610841 · NPPES record last updated May 13, 2024
Key facts
- NPI
- 1730610841
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 0401416167 (VA)
- Practice address
- 239 Trojan Rd
Madison Heights, VA 24572 - Phone
- (434) 455-2480
- NPI assigned
- Mar 21, 2017
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181019000374 | VA | Order and Referring Only - Dentist |
9931452075 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Johnson Health Center | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 0401416167 | VA | Yes |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
239 Trojan Rd
Madison Heights, VA 24572
Mailing address
22 Stewart St
Lewiston, ME 04240-3841
Phone (207) 344-9185
Other providers in Madison Heights, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 13, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.