NPIMap

Organization Active NPI

Leonard I. Nunnally DDS PC

  • General Practice Dentistry
  • Glen Allen, VA
National Provider Identifier
1730722620
Registry record updated Oct 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
LEONARD I. NUNNALLY DDS PC
Practice address
11531 Nuckols Rd Ste B
Glen Allen, VA 23059-5673
Phone
(804) 747-0908
Fax
(804) 747-1057
NPI assigned
Oct 23, 2019
Organization subpart
Yes
Parent organization
CENTRAL VIRGINIA DENTAL CARE PLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 23, 2019

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

Authorized official

Name
Dr. Leonard Nunnally IIINPI 1942403191
Title
Dentist
Phone
(804) 747-0908

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

11531 Nuckols Rd Ste B
Glen Allen, VA 23059-5673

Mailing address

11531 Nuckols Rd Ste B
Glen Allen, VA 23059-5673
Phone (804) 747-0908

National Provider Directory

National Provider Directory
Part of
Russell Mosher DDS PC

Locations

11531 Nuckols Rd
Ste B
Glen Allen, VA 23059
Phone (804) 747-0908

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.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1571788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571788800000",
    "number": "1730722620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11531 NUCKOLS RD STE B",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230595673",
            "telephone_number": "804-747-0908",
            "fax_number": "804-747-1057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11531 NUCKOLS RD STE B",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230595673",
            "telephone_number": "804-747-0908",
            "fax_number": "804-747-1057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEONARD I. NUNNALLY DDS PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRAL VIRGINIA DENTAL CARE PLC",
        "enumeration_date": "2019-10-23",
        "last_updated": "2019-10-23",
        "status": "A",
        "authorized_official_last_name": "NUNNALLY",
        "authorized_official_first_name": "LEONARD",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "804-747-0908",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III"
    },
    "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 Glen Allen, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2019; 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.