Pruden Family Dentistry

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

PRUDEN FAMILY DENTISTRY

Practice address

2303 Pruden Blvd
Suffolk, VA 23434-4330

Phone

(757) 539-9481

NPI assigned

Dec 1, 2021

Last updated

Dec 1, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

P MILTON COOK PCAs reported in NPPES

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

Authorized official

Name

Donna Renee Johnson

Title

General Manager

Phone

(757) 357-4121

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Anjali Anish Patel, DMD

  • General Practice Dentistry
  • Suffolk, VA
  • NPI 1295410975
  NPD
• Peggy M Chappell, DMD

  • General Practice Dentistry
  • Suffolk, VA
  • NPI 1770637027
  NPD (past)

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

{
    "created_epoch": "1638316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638316800000",
    "number": "1972261527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2303 PRUDEN BLVD",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234344330",
            "telephone_number": "757-539-9481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2303 PRUDEN BLVD",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234344330",
            "telephone_number": "757-539-9481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRUDEN FAMILY DENTISTRY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "P MILTON COOK PC",
        "enumeration_date": "2021-12-01",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "757-357-4121"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Suffolk, VA
• Providers in Suffolk, 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 Dec 1, 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.