Individual provider Active NPI

Daniel E Pouchot, DDS

  • Dentist
  • Charlotte Courthouse, VA
National Provider Identifier
1902002991
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401411819 Issued in VA
Practice address
165 Legrande Avenue
Charlotte Courthouse, VA 23923
Phone
(434) 542-5560
Fax
(434) 542-5745
NPI assigned
Jun 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401411819 VA Primary

Addresses

Primary practice location

165 Legrande Avenue
Charlotte Courthouse, VA 23923

Mailing address

165 Legrande Avenue
Charlotte Courthouse, VA 23923
Phone (434) 542-5560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0401411819VAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902002991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 LEGRANDE AVENUE",
            "city": "CHARLOTTE COURTHOUSE",
            "state": "VA",
            "postal_code": "23923",
            "telephone_number": "434-542-5560",
            "fax_number": "434-542-5745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 LEGRANDE AVENUE",
            "city": "CHARLOTTE COURTHOUSE",
            "state": "VA",
            "postal_code": "23923",
            "telephone_number": "434-542-5560",
            "fax_number": "434-542-5745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POUCHOT",
        "first_name": "DANIEL",
        "middle_name": "E",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401411819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte Courthouse, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.