NPIMap

Organization Active NPI

Dental Professionals of Virginia, P.C

  • General Practice Dentistry
  • Manassas, VA
National Provider Identifier
1992127989
Registry record updated Feb 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL PROFESSIONALS OF VIRGINIA, P.C
Practice address
11670 Sudley Manor Dr
Manassas, VA 20109-2842
Phone
(571) 359-6424
Fax
(571) 359-6579
NPI assigned
Jan 10, 2014
Organization subpart
Yes
Parent organization
DENTAL PROFESSIONALS OF VIRGINIA, P.CAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 24, 2014

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

Authorized official

Name
Carmen Woods
Title
Insurance/Credentialing
Phone
(217) 540-5141

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

11670 Sudley Manor Dr
Manassas, VA 20109-2842

Mailing address

11670 Sudley Manor Dr
Manassas, VA 20109-2842
Phone (571) 359-6424

Other names 1

  • Dental Care of Manassas Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Professionals of Virginia PC69 organizations share this tax ID, including this one
Part of
Dental Professionals of Virginia PC

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

11670 Sudley Manor Dr
Manassas, VA 20109
Phone (571) 359-6424

635 Pilot House Dr
Newport News, VA 23606
Phone (757) 873-2777

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1389312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393200000000",
    "number": "1992127989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11670 SUDLEY MANOR DR",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201092842",
            "telephone_number": "571-359-6424",
            "fax_number": "571-359-6579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11670 SUDLEY MANOR DR",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201092842",
            "telephone_number": "571-359-6424",
            "fax_number": "571-359-6579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONALS OF VIRGINIA, P.C",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL PROFESSIONALS OF VIRGINIA, P.C",
        "enumeration_date": "2014-01-10",
        "last_updated": "2014-02-24",
        "status": "A",
        "authorized_official_last_name": "WOODS",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_title_or_position": "INSURANCE/CREDENTIALING",
        "authorized_official_telephone_number": "217-540-5141"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Care of Manassas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Manassas, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2014; 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.