Niels Oestervemb, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401414994 Issued in VA

Practice address

633 Cedar Creek Grade
Winchester, VA 22601-3006

Phone

(540) 450-2100

Fax

(540) 662-4090

NPI assigned

Jul 15, 2010

Last updated

Feb 9, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Smiles of Virginia Family Dental Center, PLLC

  • Dental Clinic/Center
  • Winchester, VA
  • NPI 1568820702
  NPD Authorized official
• Robert D. King, D.D.S.

  • Dental Clinic/Center
  • Winchester, VA
  • NPI 1215334545
  NPD (past)

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

{
    "created_epoch": "1279152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1770896185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 CEDAR CREEK GRADE",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226012708",
            "telephone_number": "540-450-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 CEDAR CREEK GRADE",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226013006",
            "telephone_number": "540-450-2100",
            "fax_number": "540-662-4090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OESTERVEMB",
        "first_name": "NIELS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-15",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "08972",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401414994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shana Obyrne
• Clare Ocarroll, PT
• Occupational Health Services
• Melissa Anne Ochoa, NP
• Caitlin Ochs, PT, DPT
• Rebecca Ohlrogge
• Ifeanyi Okpala
• Gretchen Olazabal Shimabukuro
• Old Town ABA, LLC
• Kyle William Oldknow, FNP-C

• General Practice Dentistry in Winchester, VA
• Providers in Winchester, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2022; 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.