BASS & KAMP SOUTH MAIN LLC (NPI# 1306486840) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306486840 |
| Entity Type | Organization |
| Organization Name | BASS & KAMP SOUTH MAIN LLC |
| Practice Address |
210 Professional Park Dr Se Ste 11 Blacksburg VA 24060-6649 |
| Practice Telephone | 5409513989 |
| Enumeration Date | 2020-01-13 |
| Last Update Date | 2020-01-13 |
| Authorized Official Name | DR. JUSTIN NEIL TEBBENKAMP (MEMBER) |
| Authorized Official Telephone | 5408385050 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| New River Dental Associates | Doing Business As Name - Organization |
| Street Address |
210 PROFESSIONAL PARK DR SE STE 11 |
| City | BLACKSBURG |
| State | VA |
| Zip Code | 24060-6649 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144789215 | Center for Cognition, Language & Speech, LLC | Speech-Language Pathologist | 1999 South Main St., Suite 303, Blacksburg, VA 24060 | 2019-03-18 |
| 1669945465 | Hannah Jacqueline Lower | Physical Therapy Assistant | Kroontje Healthcare Center, 100 Litton Lane, Blacksburg, VA 24060 | 2019-01-04 |
| 1720568637 | Amy Butler | Nurse Practitioner | Blue Ridge Cancer Center, 2955 Research Drive, Blacksburg, VA 24060 | 2018-08-20 |
| 1134615321 | Benjamin Toliver Matthews | Dentist | 1400 S. Main St, Ste 1, Blacksburg, VA 24060 | 2018-07-10 |
| 1881107100 | New River Periodontics and Dental Implant Center, PC | Dentist | 2612 Sheffield Drive, Blacksburg, VA 24060 | 2017-11-08 |
| 1316333685 | Access and Mobility | Durable Medical Equipment & Medical Supplies | 2536 Blossom Trail West, Blackburg, VA 24060 | 2015-04-13 |
| 1326485202 | Kristopher Joel Hansen | Internal Medicine | 2600 Research Center Dr Ste A, Blacksburg, VA 24060 | 2013-05-31 |
| 1891038949 | Holly P. Martin | Physician Assistant | 3706 South Main Street, Suite D, Blacksburg, VA 24060 | 2013-03-27 |
| 1174875330 | Catawba Hospital | Chronic Disease Hospital | 1801 Glade Road, Blacksburg, VA 24060 | 2012-10-11 |
| 1083964316 | Karla Sue Soukup | Marriage & Family Therapist | 510 S. Main Street, Blackburg, VA 24060 | 2012-09-13 |
| Find all providers in zip 24060 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821650607 | New River Valley Dental, Pllc | Clinic/Center | 1400 S Main St Ste 1, Blacksburg, VA 24060-5506 | 2019-07-02 |
| 1841698016 | New River Periodontics and Dental Implant Center | Clinic/Center | 2612 Sheffield Dr, Blacksburg, VA 24060-8270 | 2014-12-19 |
| 1467092064 | Matthew T. Tomoda Dds PC | Clinic/Center | 614 S Main St, Blacksburg, VA 24060-5259 | 2020-01-10 |
| 1770750929 | Wallace L Huff Dds | Clinic/Center | 3708 S Main St, Blacksburg, VA 24060-7007 | 2008-05-15 |
| 1073706586 | Kimberlyn R. Atherton Dds, PC | Clinic/Center | 1400 S Main St, Suite 1401, Blacksburg, VA 24060-5528 | 2007-08-20 |
| 1306066238 | Joe A. Paget, Jr. Dds Ltd | Clinic/Center | 100 Professional Park Dr Se, Suite #2, Blacksburg, VA 24060-6665 | 2007-04-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780284679 | Dr Gina Askander PC | Clinic/Center | 4660 Kenmore Ave Ste 318, Alexandria, VA 22304-1306 | 2020-10-29 |
| 1992303242 | Anderson Dental Associates IIi, Pllc | Clinic/Center | 15609 Wingspan Ct, Woodbridge, VA 22193-1103 | 2020-10-09 |
| 1952914970 | Azul Family Dentistry LLC | Clinic/Center | 9605 Critzers Shop Rd, Afton, VA 22920-2416 | 2020-08-28 |
| 1083225429 | Long Ridge Dentistry, PC | Clinic/Center | 2780 Stuarts Draft Hwy Ste 102, Stuarts Draft, VA 24477-2779 | 2020-08-10 |
| 1942810882 | Lexington Smiles, Pllc | Clinic/Center | 123 S Randolph St, Lexington, VA 24450-2065 | 2020-08-05 |
| 1437767670 | Brad Spano Dds, P.C. | Clinic/Center | 1200 Five Springs Rd Ste 101, Charlottesville, VA 22902-8756 | 2020-07-14 |
| 1912525908 | Carabella Dental | Clinic/Center | 420 South Pickett Street, Alexandria, VA 22304-2230 | 2020-07-07 |
| 1669097044 | Lortontown Dental | Clinic/Center | 9010 Lorton Station Blvd Ste 135, Lorton, VA 22079-4794 | 2020-06-11 |
| 1578187035 | Karande Dental Care | Clinic/Center | 2063 Jefferson Davis Hwy Ste 1, Stafford, VA 22554-7291 | 2020-06-01 |
| 1326662917 | Hideki Seto, Dds Pllc | Clinic/Center | 8551 Rixlew Ln Ste 130, Manassas, VA 20109-4277 | 2020-05-30 |
| Find all providers with the same taxonomy | ||||
| City | BLACKSBURG |
| Zip Code | 24060 |
Please comment or provide details below to improve the information on BASS & KAMP SOUTH MAIN LLC.
| 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.