Active NPI
Bruce Wayne Overton, DDS
- Endodontics
- Midlothian, VA
National Provider Identifier
1992865604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 0401007578
- Practice address
- 6037 Harbour Park Drive
Midlothian, VA 23112 - Phone
- (804) 744-3636
- Fax
- (804) 744-6365
- NPI assigned
- Dec 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 0401007578 | VA | Primary |
Addresses
Primary practice location
6037 Harbour Park Drive
Midlothian, VA 23112
Mailing address
6037 Harbour Park Drive
Midlothian, VA 23112
Phone (804) 744-3636
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160502000207 | VA | Order and Referring Only - Dentist | 1850559055 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bruce W. Overton DDS PC | Endodontics | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Endodontics
- Midlothian, VA
- NPI 1609006865
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1992865604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6037 HARBOUR PARK DRIVE",
"city": "MIDLOTHIAN",
"state": "VA",
"postal_code": "23112",
"telephone_number": "804-744-3636",
"fax_number": "804-744-6365"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6037 HARBOUR PARK DRIVE",
"city": "MIDLOTHIAN",
"state": "VA",
"postal_code": "23112",
"telephone_number": "804-744-3636",
"fax_number": "804-744-6365"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OVERTON",
"first_name": "BRUCE",
"middle_name": "WAYNE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "VA",
"license": "0401007578",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Midlothian, VA
Sources for this page
- 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.