NPIMap

Organization Active NPI

Smithfiel Dental PC

  • Dentist
  • Smithfield, VA
National Provider Identifier
1881087690
Registry record updated Mar 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401412524 Issued in VA
Legal business name
SMITHFIEL DENTAL PC
Doing business as
a division of Atlantic Dental Care
Practice address
12746 Courthouse Hwy
Smithfield, VA 23430-7117
Phone
(757) 357-6779
Fax
(757) 357-2722
NPI assigned
Mar 18, 2015
Organization subpart
Yes
Parent organization
ATLANTIC DENTAL CARE, PLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 18, 2015

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

Authorized official

Name
Ms. Ashley Fallon Duck
Title
Insurance Manager
Phone
(757) 357-6779

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 0401412524 VA Primary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 0401006344 VA

Addresses

Primary practice location

12746 Courthouse Hwy
Smithfield, VA 23430-7117

Mailing address

12746 Courthouse Hwy
Smithfield, VA 23430-7117
Phone (757) 357-6779

Other names 1

  • a division of Atlantic Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
A Division of Atlantic Dental Care2 organizations share this tax ID, including this one
Part of
Melvin E Cruser III DDS

Other organizations with this tax ID 1

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 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": "1426636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426636800000",
    "number": "1881087690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12746 COURTHOUSE HWY",
            "city": "SMITHFIELD",
            "state": "VA",
            "postal_code": "234307117",
            "telephone_number": "757-357-6779",
            "fax_number": "757-357-2722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12746 COURTHOUSE HWY",
            "city": "SMITHFIELD",
            "state": "VA",
            "postal_code": "234307117",
            "telephone_number": "757-357-6779",
            "fax_number": "757-357-2722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMITHFIEL DENTAL PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ATLANTIC DENTAL CARE, PLC",
        "enumeration_date": "2015-03-18",
        "last_updated": "2015-03-18",
        "status": "A",
        "authorized_official_last_name": "DUCK",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "FALLON",
        "authorized_official_title_or_position": "INSURANCE MANAGER",
        "authorized_official_telephone_number": "757-357-6779",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401412524",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401006344",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "a division of Atlantic Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Smithfield, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2015; 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.