PROMENADE COMPLETE DENTAL CENTER (NPI# 1750838363) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750838363 |
| Entity Type | Organization |
| Organization Name | PROMENADE COMPLETE DENTAL CENTER |
| Practice Address |
19340 Promenade Drive Leesburg VA 20176 |
| Practice Telephone | 5713338558 |
| Mailing Telephone | 5713338558 |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2016-09-01 |
| Authorized Official Name | LISA CHAMPNEY (OFFICE MANAGER) |
| Authorized Official Telephone | 5713338558 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
VA | Ambulatory Health Care Facilities |
| Street Address |
19340 PROMENADE DRIVE |
| City | LEESBURG |
| State | VA |
| Zip Code | 20176 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053912923 | Timothy Michael Nixon | Pharmacist | 61 Catoctin Circle, Leesburg, VA 20176 | 2020-11-05 |
| 1558996645 | Stacey E Moran | Occupational Therapist | 44124 Woodrige Parkway, Lansdowne, VA 20176 | 2020-03-09 |
| 1710531272 | Joseph H Kasuska Jr. | Specialist/Technologist | 19455 Deerfield Ave. Suite 306, Lansdowne, VA 20176 | 2019-08-01 |
| 1568935849 | Joel Manalang Polintan Jr. | Physical Therapist | 171 Cedarwalk Circle, Leesburg, VA 20176 | 2019-01-09 |
| 1194203026 | Jing Cao | Acupuncturist | 19450 Deerfield Ave Ste 275, Leesburg, VA 20176 | 2018-08-02 |
| 1134648314 | Alaina Marie Gotwalt | Speech-Language Pathologist | 43850 Heatherstone Terrace, Unit 406, Leesburg, VA 20176 | 2017-09-19 |
| 1841717105 | Happy Inhome Care Corp | Respite Care | 722 E Market St Ste 103, Leesburg, VA 20176 | 2017-08-28 |
| 1912423484 | Aaa Good Healthcare LLC | Nursing Care | 722 East Market Street Ne, Suite 102, Leesburg, VA 20176 | 2017-08-16 |
| 1740704253 | Anna Maria Domingo Seaford | Physician Assistant | 19441 Golf Vista Plz Ste 230, Lansdowne, VA 20176 | 2017-07-27 |
| 1710436480 | Reena Patel | Physician Assistant | 224 Cornwall St Nw Leesburg Orthope, Unit 204, Leesburg, VA 20176 | 2016-09-23 |
| Find all providers in zip 20176 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841851227 | A & A Brothers, LLC | Clinic/Center | 8305 County Road 44 Leg A # 1, Leesburg, FL 34788-3706 | 2019-06-26 |
| 1003479627 | Nova Lifesmiles Pllc | Clinic/Center | 17 Fort Evans Rd Ne Ste C, Leesburg, VA 20176-4400 | 2019-04-18 |
| 1992290415 | Mossy Oak Dental, LLC | Clinic/Center | 119 Carlton Dr, Leesburg, GA 31763-5652 | 2018-06-27 |
| 1033657051 | Garima K Talwar Dds. Plc | Clinic/Center | 1602 Village Market Blvd Se Ste 130, Leesburg, VA 20175-4721 | 2017-02-09 |
| 1508001314 | Saxena Dental Inc | Clinic/Center | 552 Fort Evans Rd, Suite 100, Leesburg, VA 20176-4098 | 2008-12-08 |
| 1740841865 | Leesburg Smiles | Clinic/Center | 8305 County Road 44 Leg A # 1, Leesburg, FL 34788-3706 | 2019-06-28 |
| 1083112395 | Ali M Mualla Dds Pllc | Clinic/Center | 545 E Market St Ste G, Leesburg, VA 20176-4172 | 2018-02-01 |
| 1154879732 | Shireen Dhanani Dmd Pa | Clinic/Center | 918 E Dixie Ave, Leesburg, FL 34748-7647 | 2016-09-13 |
| 1598146318 | Avatar Dental Care | Clinic/Center | 545 E Market St Ste G, Leesburg, VA 20176-4172 | 2015-06-17 |
| 1174952683 | Mauricio Garcia, Dds, Pllc | Clinic/Center | 21 Fort Evans Rd Ne Ste E, Leesburg, VA 20176-4488 | 2013-11-05 |
| Find all providers in LEESBURG | ||||
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| 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.