Marissa Deangelis, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

0401413875 Issued in VA

Practice address

5690 Three Notch D Rd Ste 100
Crozet, VA 22932-3173

Phone

(434) 823-4080

NPI assigned

Jun 21, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• James W Willis DDS PLC

  • Dentist
  • Crozet, VA
  • NPI 1972210268
  NPD
• Aesthetic Dentistry of Charlottesville, P.C.

  • Dentist
  • Charlottesville, VA
  • NPI 1700929395
  NPD (past)
• Brad Spano DDS, P.C.

  • Dental Clinic/Center
  • Charlottesville, VA
  • NPI 1437767670
  NPD (past)

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

{
    "created_epoch": "1371772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1992144018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 4TH ST SW",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229035501",
            "telephone_number": "703-244-3958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5690 THREE NOTCH D RD STE 100",
            "city": "CROZET",
            "state": "VA",
            "postal_code": "229323173",
            "telephone_number": "434-823-4080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEANGELIS",
        "first_name": "MARISSA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-21",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401413875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crozet Internal Medicine, PLC
• Crozet Operations LLC
• Crozet Pediatric Dentistry, PC
• Aisling Cuffe, DPT
• Morgan R Davis, R.D.
• Dana E Delaney, COTA/L
• Laura Dowell, MSW
• Sophia Catherine Ellia
• Bryan Esherick, PT, DPT
• Everloom LLC

• All providers in Crozet, VA
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; 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.