KING & QUEEN COUNTY DENTAL CLINIC (NPI# 1568574796) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568574796 |
| Entity Type | Organization |
| Organization Name | KING & QUEEN COUNTY DENTAL CLINIC |
| Other Organization Name | THREE RIVERS HEALTH DISTRICT |
| Practice Address |
167 Courthouse Landing Road King & Queen VA 23805-0008 |
| Mailing Address |
167 Courthouse Landing Road P O Box 8 King & Queen VA 23086 |
| Practice Telephone | 8047582381 |
| Practice Fax Number | 8047584828 |
| Mailing Telephone | 8047582381 |
| Mailing Fax Number | 8047584828 |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2008-07-10 |
| Authorized Official Name | DR. DANIEL LAWRENCE (HEALTH DEPTS DENTIST) |
| Authorized Official Telephone | 8047582381 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | Y |
| Parent Organization Name | THREE RIVERS HEALTH DISTRICT |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251K00000X | Public Health or Welfare | 0401004548 | VA | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 8451222 | 05 | |
| VA | DORAL (VA SMILES) | 106881 | 01 |
| Other Name | Type Code |
|---|---|
| THREE RIVERS HEALTH DISTRICT | Doing Business As Name - Organization |
| Street Address |
167 COURTHOUSE LANDING ROAD |
| City | KING & QUEEN |
| State | VA |
| Zip Code | 23805-0008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134690647 | Miles Viant | Occupational Therapist | 287 E Blvd, Petersburg, VA 23805 | 2018-12-10 |
| 1245756964 | Dexter Shabazz Lett | Registered Nurse | 10543 S. Crater Rd, S. Prince George, VA 23805 | 2017-08-15 |
| 1891145876 | Taylor Enhanced Living | Counselor | 105 Holly Hill Dive, Suite A, Petersburg, VA 23805 | 2016-06-21 |
| 1700255205 | Ina Thompson | Counselor | 272 Medical Park Boulevard, Petersburg, VA 23805 | 2015-09-15 |
| 1932582541 | Valeria Edda Madrid Malo Bohorquez | Internal Medicine | 50 Medical Park Blvd Ste C, Petersburg, VA 23805 | 2015-06-30 |
| 1548642788 | Justin Andrew Phillingane | Podiatrist | 3335 S Crater Rd Ste 500, Petersburg, VA 23805 | 2015-06-24 |
| 1225417082 | Paladin Dermatology LLC | Nurse Practitioner | 44 A& B Medical Park Blvd, Petersburg, VA 23805 | 2015-05-27 |
| 1245652544 | Family Services Inc. | Health Maintenance Organization | 1045 Gustavo Lane, Petersburg, VA 23805 | 2014-01-06 |
| 1619268075 | Charlene Belangia | Massage Therapist | 3323 S. Crater Rd, Suite B, Petersburg, VA 23805 | 2011-04-20 |
| 1760709638 | Caresouth Hha Holdings of Virginia, LLC | Home Health | 34 Medical Park Boulevard, Suite G-h, Petersburg, VA 23805 | 2010-04-30 |
| Find all providers in zip 23805 | ||||
| Taxonomy Code | 251K00000X |
| Grouping | Agencies |
| Classification | Public Health or Welfare |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326647702 | Lowe Physiotherapy, LLC | Public Health or Welfare | 1220 N Taylor St, Arlington, VA 22201-4814 | 2020-10-18 |
| 1538767793 | Warminster Place LLC | Public Health or Welfare | 7020 Old Mill Road, Norfolk, VA 23518 | 2020-10-11 |
| 1013538719 | Qualified Concepts, LLC | Public Health or Welfare | 15830 Hampton Park Cir, Chesterfield, VA 23832-1900 | 2020-05-04 |
| 1477174472 | Astyra Corporation | Public Health or Welfare | 411 E Franklin St Ste 105, Richmond, VA 23219-2243 | 2020-04-30 |
| 1538780945 | The Eagleforce Foundation Inc | Public Health or Welfare | 13241 Woodland Park Rd Ste 600, Herndon, VA 20171-6401 | 2020-04-27 |
| 1124688536 | Here's 2 Life | Public Health or Welfare | 6023 Riddle Walk, Alexandria, VA 22312-2773 | 2019-06-18 |
| 1750848925 | Aaa Health Care Services LLC | Public Health or Welfare | 9525 Pine Trails Ct, Henrico, VA 23294-5344 | 2019-02-25 |
| 1720523996 | Arthur Chiu | Public Health or Welfare | 7619 Huntmaster Ln, Mc Lean, VA 22102-2531 | 2016-12-27 |
| 1528409257 | Rx4relief, LLC | Public Health or Welfare | 82 Watermans Ct, Gasburg, VA 23857-2204 | 2013-07-10 |
| 1003163338 | Gma Construction LLC | Public Health or Welfare | 166 Holden Dr, Manassas Park, VA 20111-1832 | 2012-08-06 |
| Find all providers with the same taxonomy | ||||
| City | KING & QUEEN |
| Zip Code | 23805 |
Please comment or provide details below to improve the information on KING & QUEEN COUNTY DENTAL CLINIC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.