NPIMap

Organization Active NPI

Robert N. Penterson, DDS, PC

  • General Practice Dentistry
  • Midlothian, VA
National Provider Identifier
1891905923
Registry record updated Jul 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401411024 Issued in VA
Legal business name
ROBERT N. PENTERSON, DDS, PC
Practice address
5954 Harbour Park Dr
Midlothian, VA 23112-2163
Phone
(804) 739-1600
Fax
(804) 739-9035
NPI assigned
May 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2014

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

Authorized official

Name
Dr. Stephen Clarence Booth, DDSNPI 1457445314
Title
Treasurer
Phone
(804) 739-1600

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 0401411024 VA Primary

Addresses

Primary practice location

5954 Harbour Park Dr
Midlothian, VA 23112-2163

Mailing address

5954 Harbour Park Dr
Midlothian, VA 23112-2163
Phone (804) 739-1600

Other names 1

  • Penterson and Booth, DDS Doing business as

National Provider Directory

National Provider Directory

Locations

5954 Harbour Park Dr
Midlothian, VA 23112
Phone (804) 597-9656

Practitioners & affiliated clinicians

Practitioners 2

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": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404172800000",
    "number": "1891905923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5954 HARBOUR PARK DR",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231122163",
            "telephone_number": "804-739-1600",
            "fax_number": "804-739-9035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5954 HARBOUR PARK DR",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231122163",
            "telephone_number": "804-739-1600",
            "fax_number": "804-739-9035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT N. PENTERSON, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2014-07-01",
        "status": "A",
        "authorized_official_last_name": "BOOTH",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "CLARENCE",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "804-739-1600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401411024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Penterson and Booth, DDS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Midlothian, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2014; 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.