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COMMONWEALTH PEDIATRIC DENTISTRY PLLC NPI 1982140620


NPI Information

NPI: 1982140620
Provider Name: COMMONWEALTH PEDIATRIC DENTISTRY, PLLC
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

CLIA Number: 49D0867674

Address:
6661 LAKE HARBOUR DR
MIDLOTHIAN, VA
ZIP 23112
Phone: (804) 363-4283
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COMMONWEALTH PEDIATRIC DENTISTRY, PLLC is a general practice dentist in Midlothian, VA. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. COMMONWEALTH PEDIATRIC DENTISTRY, PLLC NPI is 1982140620. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

6661 LAKE HARBOUR DR
MIDLOTHIAN, VA
ZIP 23112-082
Phone: (804) 363-4283

The provider's authorized official is Lauri Henderson .
The authorized official title is Administrative Assistant and has the following contact phone number (804) 363-4283.

The CLIA number assigned to this NPI record is 49D0867674 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 1/18/2017 and was last updated on 1/18/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral PracticeYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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