KOOL SMILES VAN, PC (NPI# 1255418331) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255418331 |
| Entity Type | Organization |
| Organization Name | KOOL SMILES VAN, PC |
| Other Organization Name | KOOL SMILES |
| Practice Address |
400c Southpark Blvd Colonial Heights VA 23834-2974 |
| Mailing Address |
1090 Northchase Pkwy Se Ste 150 Marietta GA 30067-6407 |
| Practice Telephone | 6789045665 |
| Practice Fax Number | 6789045669 |
| Mailing Telephone | 7709165028 |
| Mailing Fax Number | 6782477858 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2014-12-19 |
| Authorized Official Name | DR. TU TRAN (PRESIDENT) |
| Authorized Official Telephone | 7709165028 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers | ||
| N | 1223E0200X |
Dentist Specialization: Endodontics |
Dental Providers | ||
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Kool Smiles | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609162460 | Kool Smiles Van, PC | Dentist | 2065 S Pleasant Valley Rd, Winchester, VA 22601-7001 | 2011-06-21 |
| 1619262391 | Kool Smiles Van, PC | Dentist | 365 Lowes Dr, Danville, VA 24540-5900 | 2011-06-10 |
| 1417242199 | Kool Smiles Van, PC | Dentist | 135 Conston Ave, Christiansburg, VA 24073-1151 | 2011-06-10 |
| 1447443080 | Kool Smiles Van, PC | Dentist | 3533 Plank Rd, Suite #a, Fredericksburg, VA 22407-6830 | 2007-08-27 |
| 1255524120 | Kool Smiles Van, PC | Dentist | 2000 Daniel Stuart Sq, Woodbridge, VA 22191-3315 | 2007-08-23 |
| 1780771378 | Kool Smiles Van, PC | Dentist | 4239 Holland Road, Suite 762-a, Virginia Beach, VA 23452 | 2006-10-06 |
| 1275620866 | Kool Smiles Van, PC | Dentist | 4072 Victory Blvd., Portsmouth, VA 23701 | 2006-10-06 |
| 1790872380 | Kool Smiles Van, PC | Dentist | 14346 Warwick Blvd., #9, Newport News, VA 23608 | 2006-10-06 |
| 1609963297 | Kool Smiles Van, PC | Dentist | 2165 Cunningham Drive, Hampton, VA 23666 | 2006-10-06 |
| 1366539959 | Kool Smiles Van, PC | Dentist | 6537-b Arlington Blvd., Falls Church, VA 22044 | 2006-10-06 |
| Street Address |
400C SOUTHPARK BLVD |
| City | COLONIAL HEIGHTS |
| State | VA |
| Zip Code | 23834-2974 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356871883 | Naga Sucharitha Tadepalli | Dentist | 400c Southpark Blvd, Colonial Heights, VA 23834-2974 | 2017-06-18 |
| 1255881868 | Huiyan Guan | Dentist | 400c Southpark Blvd, Colonial Heights, VA 23834-2974 | 2016-10-06 |
| 1407206899 | Roxana Anvari-tehrani | Dentist | 400c Southpark Blvd, Colonial Heights, VA 23834-2974 | 2016-06-15 |
| 1831530211 | Davina Bailey | Dentist | 400c Southpark Blvd, Colonial Heights, VA 23834-2974 | 2013-07-12 |
| 1366704397 | Emily M Dimitroff | Dentist | 400c Southpark Blvd, Colonial Heights, VA 23834-2974 | 2012-06-14 |
| 1710274998 | Blair E Witt | Dentist | 400c Southpark Blvd, Colonial Heights, VA 23834-2974 | 2011-07-07 |
| 1407186752 | Supraja Bilakanti | Dentist | 400c Southpark Blvd, Colonial Heights, VA 23834-2974 | 2010-01-09 |
| 1336347343 | Osama Odeh | Dentist | 400c Southpark Blvd, Kool Smiles, Colonial Heights, VA 23834-2974 | 2007-07-11 |
| 1720139074 | Rashmi Goswami | Dentist | 400c Southpark Blvd, Colonial Heights, VA 23834-2974 | 2007-01-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093323040 | Latoya Harris | Social Worker | 3220 Loganwood Dr, South Chesterfield, VA 23834 | 2020-07-15 |
| 1619598653 | Jasmine Cutler | Nurse Practitioner | 445 Charles Dimmock Pkwy, Colonial Heights, VA 23834 | 2020-04-30 |
| 1942841275 | Stephanie Benedict | Technician | 330 King Fisher Way, Col. Heights, VA 23834 | 2019-10-08 |
| 1134628852 | Stacie J Lewis | Hearing Instrument Specialist | 320b Charles Dimmock Pkwy, Suite 4, Colonial Heights, VA 23834 | 2018-02-08 |
| 1073020194 | Colonial Heights Physicians, LLC | Emergency Medicine | 60 East Roslyn Court, Colonial Heights, VA 23834 | 2018-01-10 |
| 1639681349 | Nicholas C Vickers | Hearing Instrument Specialist | 320 B Charles Dimmock Pkwy, Suite 4, Colonial Heights, VA 23834 | 2017-11-03 |
| 1962935015 | Selfless Service LLC | In Home Supportive Care | 256 E Ellerslie Ave Ste C, Colonial Heights, VA 23834 | 2017-04-05 |
| 1134594864 | Dominion Aba | Early Intervention Provider Agency | 2903 Bouleavard, Colonial Heights, VA 23834 | 2015-12-07 |
| 1558743039 | Dream Care of Va LLC | Durable Medical Equipment & Medical Supplies | 130 Temple Lake Dr Ste 4, Colonial Heights, VA 23834 | 2015-06-22 |
| 1811311343 | Colonial Orthopaedics Inc | Orthopaedic Surgery | 325 Charles Dimmock Parkway, Suite 301, Colonial Heights, VA 23834 | 2014-02-04 |
| Find all providers in zip 23834 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| 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. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437601895 | Richard W Bates Dds | Dentist | 3610 Boulevard Ste A, Colonial Heights, VA 23834-1329 | 2016-11-01 |
| 1316233851 | Basil Jackson Friend II | Dentist | 15806 Jefferson Davis Hwy, Colonial Heights, VA 23834-5202 | 2011-06-23 |
| 1265725691 | Yosreldin Koheil | Dentist | 723 S Park Blvd, Suite F, Colonial Heights, VA 23834-3628 | 2011-05-18 |
| 1609990373 | Joseph Wayne Browder | Dentist | 209 Temple Ave, Colonial Heights, VA 23834-2827 | 2007-03-19 |
| 1992859771 | Richard W Bates | Dentist | 3610 Boulevard, Suite A, Colonial Heights, VA 23834-1329 | 2007-01-22 |
| 1750439261 | Ralph Jennings Rutledge Jr. | Dentist | 3401 Boulevard, Colonial Heights, VA 23834-1417 | 2007-01-08 |
| 1811065410 | Phyllis Gee Sum Greer | Dentist | 456 Charles H Dimmock Pkwy Ste 5, Colonial Heights, VA 23834-2936 | 2006-12-01 |
| 1861485393 | June Keller Vernon | Dentist | 241 Charles H Dimmock Pkwy, Suite 2, Colonial Heights, VA 23834-2915 | 2005-08-30 |
| 1740286533 | Richard Fleming Roadcap | Dentist | 3501 Boulevard, Colonial Heights, VA 23834-1319 | 2005-06-26 |
| 1538653209 | Clinton Mitchell Meadows | Dentist | 456 Charles H Dimmock Pkwy Ste 5, Colonial Heights, VA 23834-2936 | 2018-06-18 |
| Find all providers in COLONIAL HEIGHTS | ||||
| City | COLONIAL HEIGHTS |
| Zip Code | 23834 |
Please comment or provide details below to improve the information on KOOL SMILES VAN, PC.
| 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.