Southside Dental Cares, PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SOUTHSIDE DENTAL CARES, PC

Practice address

2731 S Crater Rd
Petersburg, VA 23805-2403

Phone

(804) 732-8557

NPI assigned

Jan 19, 2022

Organization subpart

No

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

Authorized official

Name

Mrs. Barbara Hepner

Title

Manager

Phone

(804) 290-8001

Specialties & licenses 1

Addresses

Locations

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.

• Behnaz Movahed-Ardakani, D.D.S

  • General Practice Dentistry
  • Glen Allen, VA
  • NPI 1922584374
  NPD (past)

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

{
    "created_epoch": "1642550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642550400000",
    "number": "1962154252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5231 HICKORY PARK DR STE E",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230592619",
            "telephone_number": "804-290-8001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2731 S CRATER RD",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238052403",
            "telephone_number": "804-732-8557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE DENTAL CARES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-19",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A",
        "authorized_official_last_name": "HEPNER",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "804-290-8001",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Soft Life Therapeutics LLC
• Crystal Sue Luckett Solomon, LPC
• South Leasing (VA) Co., LLC (Petersburg Healthcare Center)
• Southerncare Inc (SouthernCare Petersburg)
• Southside Dental Associates PC
• Southside Family Practice P.C.
• Southside Kidney Specialists
• Southside Kidney Specialists
• Southside OB-GYN, Inc.
• Southside Physicians for Women, LLC

• Dental Clinic/Center in Petersburg, VA
• Providers in Petersburg, VA by specialty
• Dental Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; 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.