NPIMap

Organization Active NPI

Pediatric Dentistry & Orthodontics of VA

  • General Practice Dentistry
  • Midlothian, VA
National Provider Identifier
1730627357
Registry record updated Feb 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
PEDIATRIC DENTISTRY & ORTHODONTICS OF VA
Practice address
13841 Hull Street Rd
Suite 4
Midlothian, VA 23112-2056
Phone
(804) 739-0963
Fax
(804) 739-0965
NPI assigned
Feb 2, 2017
Organization subpart
Yes
Parent organization
CENTRAL VIRGINIA DENTAL CAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 2, 2017

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

Authorized official

Name
Dr. David L Keeton, D.M.D.
Title
Manager
Phone
(804) 739-0963

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

13841 Hull Street Rd
Suite 4
Midlothian, VA 23112-2056

Mailing address

651 Southpark Blvd
Colonial Heights, VA 23834-3617
Phone (804) 536-9815

National Provider Directory

National Provider Directory
Tax ID family
Russell Mosher DDS PC6 organizations share this tax ID, including this one
Part of
Russell Mosher DDS PC

Other organizations with this tax ID 5

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

Locations

651 Southpark Blvd
Colonial Heights, VA 23834

NPI Registry JSON

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

{
    "created_epoch": "1485993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485993600000",
    "number": "1730627357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 SOUTHPARK BLVD",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238343617",
            "telephone_number": "804-536-9815",
            "fax_number": "804-526-9866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13841 HULL STREET RD",
            "address_2": "SUITE 4",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231122056",
            "telephone_number": "804-739-0963",
            "fax_number": "804-739-0965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTISTRY & ORTHODONTICS OF VA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRAL VIRGINIA DENTAL CARE",
        "enumeration_date": "2017-02-02",
        "last_updated": "2017-02-02",
        "status": "A",
        "authorized_official_last_name": "KEETON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "804-739-0963",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2017; 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.