NPIMap

Organization Active NPI

Phillip D Prater DDD PLLC

  • Dentist
  • Blackstone, VA
National Provider Identifier
1891186441
Registry record updated Feb 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401414364 Issued in VA
Legal business name
PHILLIP D PRATER DDD PLLC
Practice address
929 S Main St
Blackstone, VA 23824-2610
Phone
(434) 292-3695
NPI assigned
Feb 17, 2015
Last updated
Feb 17, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2015

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

Authorized official

Name
Dr. Phillip D Prater, DDS
Title
Owner
Phone
(434) 292-3695

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401414364 VA Primary

Addresses

Primary practice location

929 S Main St
Blackstone, VA 23824-2610

Mailing address

929 S Main St
Blackstone, VA 23824-2610

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1424131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424131200000",
    "number": "1891186441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "929 S MAIN ST",
            "city": "BLACKSTONE",
            "state": "VA",
            "postal_code": "238242610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 S MAIN ST",
            "city": "BLACKSTONE",
            "state": "VA",
            "postal_code": "238242610",
            "telephone_number": "434-292-3695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLIP D PRATER DDD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-17",
        "last_updated": "2015-02-17",
        "status": "A",
        "authorized_official_last_name": "PRATER",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "434-292-3695",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401414364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blackstone, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 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.