NPIMap

Organization Active NPI

Tremont Road Dental, PC

Doing business as Spencer Dental

  • General Practice Dentistry
  • Virginia Beach, VA
National Provider Identifier
1780771378
Registry record updated May 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
TREMONT ROAD DENTAL, PC
Doing business as
Spencer Dental
Practice address
4239 Holland Road
Suite 762-a
Virginia Beach, VA 23452
Phone
(757) 467-5665
Fax
(757) 467-1455
NPI assigned
Oct 6, 2006
Last updated
May 27, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2022

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

Authorized official

Name
Michelle Jacomino
Title
Director of Payor Relations
Phone
(770) 916-5036

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X NU
General Practice Dentistry 1223G0001X NU Primary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X NU

Addresses

Primary practice location

4239 Holland Road
Suite 762-a
Virginia Beach, VA 23452

Mailing address

210 Interstate North Pkwy SE Ste 300
Atlanta, GA 30339-2233
Phone (770) 916-9000

Other names 1

  • Spencer Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Spencer Dental18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Locations

4239 Holland Rd
Ste 762A
Virginia Beach, VA 23452
Phone (757) 467-5665

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653609600000",
    "number": "1780771378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 INTERSTATE NORTH PKWY SE STE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303392233",
            "telephone_number": "770-916-9000",
            "fax_number": "678-247-7858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4239 HOLLAND ROAD",
            "address_2": "SUITE 762-A",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "23452",
            "telephone_number": "757-467-5665",
            "fax_number": "757-467-1455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TREMONT ROAD DENTAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-27",
        "status": "A",
        "authorized_official_last_name": "JACOMINO",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "DIRECTOR OF PAYOR RELATIONS",
        "authorized_official_telephone_number": "770-916-5036"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spencer Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.