M Minnieville Dental Care PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

M MINNIEVILLE DENTAL CARE PLLC

Doing business as

Momentum Dental

Practice address

14389 Hereford Rd
Woodbridge, VA 22193-2107

Phone

(703) 878-8000

NPI assigned

Dec 7, 2020

Last updated

Feb 17, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

MOMENTUM DENTAL CAREAs reported in NPPES

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

Authorized official

Name

Gelly Rivas Osorio

Title

Operations Manager

Phone

(703) 589-7040

Specialties & licenses 1

Addresses

Other names 1

• Momentum Dental Doing business as

Electronic endpoints 1

Locations

Interoperability endpoints

• Direct secure messaging: guestservices@momentumdentalcare.com

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.

• Tamesha Morris, DDS

  • General Practice Dentistry
  • Dumfries, VA
  • NPI 1073708905
  NPD

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

{
    "created_epoch": "1607299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613520000000",
    "number": "1952907842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4222 FORTUNA CENTER PLZ # 637",
            "city": "DUMFRIES",
            "state": "VA",
            "postal_code": "220251515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14389 HEREFORD RD",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221932107",
            "telephone_number": "703-878-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M MINNIEVILLE DENTAL CARE PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MOMENTUM DENTAL CARE",
        "enumeration_date": "2020-12-07",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A",
        "authorized_official_last_name": "RIVAS OSORIO",
        "authorized_official_first_name": "GELLY",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "703-589-7040"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "guestservices@momentumdentalcare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "14389 Hereford Rd",
            "city": "Woodbridge",
            "state": "VA",
            "country_code": "US",
            "postal_code": "221932107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Momentum Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Momentum Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lyon Home Health Care LLC
• Diana Marie Lyons, BCBA, LBA
• Katherine D Lyons, PA-C
• Alexis Lytle, AS, BCAT
• M & M Pathology PLLC
• M. Hossein Razavi, MD PC
• M.a.K. Superior Home Health LLC
• M. Bernadette Macdonald, APRN-PMH
• Priscilla Maclomotey
• Kayla C. Macri, D.M.D.

• Dentist in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2021; 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.