NPIMap

Organization Active NPI

Sparkle Pediatric Dentistry

  • Pediatric Dentistry
  • Henrico, VA
National Provider Identifier
1821535444
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
SPARKLE PEDIATRIC DENTISTRY
Doing business as
Sparkle Pediatric Dentistry
Practice address
11934 W Broad St Ste 120
Henrico, VA 23233-1100
Phone
(804) 746-7382
Fax
(804) 746-3025
NPI assigned
Jan 20, 2017
Last updated
Sep 23, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
CENTRAL VIRGINIA DENTAL CARE PLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

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

Authorized official

Name
Holly C Lewis, DMD, MSNPI 1073548947
Title
Pediatric Dental Specialist
Phone
(804) 746-7382

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
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

11934 W Broad St Ste 120
Henrico, VA 23233-1100

Mailing address

11934 W Broad St Ste 120
Henrico, VA 23233-1100
Phone (804) 746-7382

Other names 1

  • SPARKLE PEDIATRIC DENTISTRY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
DRS Rossetti Cosby Kondrossy DDS LC6 organizations share this tax ID, including this one
Part of
DRS Rossetti Cosby Kondrossy DDS LC

Other organizations with this tax ID 5

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

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 3

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": "1484870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632355200000",
    "number": "1821535444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11934 W BROAD ST STE 120",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232331100",
            "telephone_number": "804-746-7382",
            "fax_number": "804-746-3025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11934 W BROAD ST STE 120",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232331100",
            "telephone_number": "804-746-7382",
            "fax_number": "804-746-3025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARKLE PEDIATRIC DENTISTRY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRAL VIRGINIA DENTAL CARE PLC",
        "enumeration_date": "2017-01-20",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PEDIATRIC DENTAL SPECIALIST",
        "authorized_official_telephone_number": "804-746-7382",
        "authorized_official_credential": "DMD, MS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SPARKLE PEDIATRIC DENTISTRY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Henrico, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; 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.