Diana Marchibroda, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401005845 Issued in VA

Practice address

9605 Critzer Shop Rd
Afton, VA 22920-2416

Phone

(540) 456-6571

Fax

(540) 456-6535

NPI assigned

Jul 4, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Azul Family Dentistry LLC

  • Dental Clinic/Center
  • Afton, VA
  • NPI 1952914970
  NPD (past)

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972533826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 NEWTOWN RD",
            "city": "GREENWOOD",
            "state": "VA",
            "postal_code": "229431700",
            "telephone_number": "540-456-8532",
            "fax_number": "540-456-6535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9605 CRITZER SHOP RD",
            "city": "AFTON",
            "state": "VA",
            "postal_code": "229202416",
            "telephone_number": "540-456-6571",
            "fax_number": "540-456-6535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCHIBRODA",
        "first_name": "DIANA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401005845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7805284",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dragonfly Medical Transport LLC
• Grazia Foundation
• Ryan D Hall, DCN,CNS, LDN
• Matthew Scott Hudson, D.C.
• Jesse Luckett PC
• Dawn Monroe
• Gladys A. Perkins
• PT Plus of Afton, LLC (PT Plus)
• William Ronald Pulliam, L.P.C.
• Anne T Roane, NP

• General Practice Dentistry in Afton, VA
• Providers in Afton, VA by specialty
• General Practice Dentistry in Virginia

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.