Individual provider Active NPI

Ashley Rebecca Anderson, DDS

  • Pediatric Dentistry
  • Norfolk, VA
National Provider Identifier
1891223913
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
0401415645 Issued in VA
Practice address
301 Riverview Ave Ste 300
Norfolk, VA 23510-1066
Phone
(757) 668-7713
Fax
(757) 668-7711
NPI assigned
Jun 2, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Dentistry 1223P0221X 0401415645 VA Primary

Addresses

Primary practice location

301 Riverview Ave Ste 300
Norfolk, VA 23510-1066

Mailing address

601 Childrens LN
Norfolk, VA 23507-1910
Phone (577) 668-7713

Other practice location 1

601 Childrens Ln
Norfolk, VA 23507-1910
Phone (757) 668-7713

Other practice location 2

2021 Concert Dr
Virginia Beach, VA 23456-8082
Phone (757) 668-7713

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171019002480 SC Order and Referring Only - DentistPractitioner - Dentist 6103192067

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Surgical Specialty Group, Inc Past Accepting new patients
Pediatric Dental Care of Tidewater PC PastSince Dec 22, 2024 Accepting new patients
Pediatric Dental Care of Tidewater PC Pediatric Dentistry PastSince Mar 1, 2020 Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1496361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1891223913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 CHILDRENS LN",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071910",
            "telephone_number": "577-668-7713",
            "fax_number": "757-668-7711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 RIVERVIEW AVE STE 300",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235101066",
            "telephone_number": "757-668-7713",
            "fax_number": "757-668-7711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 Childrens Ln",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235071910",
            "country_code": "US",
            "telephone_number": "757-668-7713",
            "fax_number": "757-668-7711",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2021 Concert Dr",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234568082",
            "country_code": "US",
            "telephone_number": "757-668-7713",
            "fax_number": "757-668-7711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ASHLEY",
        "middle_name": "REBECCA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-02",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "VA",
            "license": "0401415645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.