Individual provider Active NPI

Perry L Showalter, D.D.S.

  • Dentist
  • Yorktown, VA
National Provider Identifier
1912947094
Registry record updated Jun 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401006567 Issued in VA
Practice address
4326 George Washington Memorial Highway
Yorktown, VA 23692
Phone
(757) 898-6788
Fax
(757) 898-1042
NPI assigned
Jun 7, 2006
Last updated
Jun 16, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6567 VA
Dentist 122300000X 0401006567 VA Primary
General Practice Dentistry 1223G0001X 0401006567 VA

Addresses

Primary practice location

4326 George Washington Memorial Highway
Yorktown, VA 23692

Mailing address

4326 George Washington Memorial Highway
Yorktown, VA 23692
Phone (757) 898-6788

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
0401006567VAMDDentist
6567VAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Yorktown Dental, PLLC Dentist Past Accepting new patients
Yorktown Dental General Practice Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466035200000",
    "number": "1912947094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4326 GEORGE WASHINGTON MEMORIAL HIGHWAY",
            "city": "YORKTOWN",
            "state": "VA",
            "postal_code": "23692",
            "telephone_number": "757-898-6788",
            "fax_number": "757-898-1042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4326 GEORGE WASHINGTON MEMORIAL HIGHWAY",
            "city": "YORKTOWN",
            "state": "VA",
            "postal_code": "23692",
            "telephone_number": "757-898-6788",
            "fax_number": "757-898-1042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOWALTER",
        "first_name": "PERRY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2016-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "6567",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401006567",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401006567",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yorktown, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2016; 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.