DENTAL CENTER @ LAKE RIDGE (NPI# 1801242466) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801242466 |
| Entity Type | Organization |
| Organization Name | DENTAL CENTER @ LAKE RIDGE |
| Practice Address |
12764 Darby Brook Ct Woodbridge VA 22192-2486 |
| Practice Telephone | 7034998888 |
| Mailing Telephone | 7034998888 |
| Enumeration Date | 2016-05-12 |
| Last Update Date | 2016-05-12 |
| Authorized Official Name | DR. THAO DOAN (OWNER) |
| Authorized Official Telephone | 7034998888 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 0401410245 | VA | Ambulatory Health Care Facilities |
| Street Address |
12764 DARBY BROOK CT |
| City | WOODBRIDGE |
| State | VA |
| Zip Code | 22192-2486 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215915186 | Thao Phuong Doan | Dentist | 12764 Darby Brook Ct, Woodbridge, VA 22192-2486 | 2006-01-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245873645 | Ursula Jackson | Technician | 3500 Commission Ct, Woodbridge, VA 22192 | 2019-10-18 |
| 1205480779 | Ki Soo Park | Physical Therapy Assistant | 12825 Minnieville Road Suite 201, Lake Ridge, VA 22192 | 2019-08-01 |
| 1801448329 | Karen Lee Trivett | Specialist/Technologist, Other | 12584 Darby Brook Court, Woodbridge, VA 22192 | 2019-07-15 |
| 1407313166 | Nichele Amelia Thompson | Behavioral Analyst | 2731 Marblestone Dr, 101, Woodbridge, VA 22192 | 2019-02-28 |
| 1952877870 | Kimberly Ann Rojas Vazquez | Behavioral Analyst | 12531 Clipper Dr, Suite 203, Woodbridge, VA 22192 | 2018-10-18 |
| 1104391614 | Ykim Dental | Dentist | 2680 Optiz Blvd., Suite 120, Woodbridge, VA 22192 | 2018-10-11 |
| 1013418755 | Arm Transport | Non-emergency Medical Transport (VAN) | 13000 Harbor Center Dr Ste 132d, Woodbridge, VA 22192 | 2018-02-27 |
| 1811496813 | Francesca Nasi | Behavioral Analyst | 12531 Clipper Dr Ste 203, Woodbridge, VA 22192 | 2018-02-05 |
| 1942729504 | Bismark Transportation Service LLC | Non-emergency Medical Transport (VAN) | 12341 Woodlawn Court, Woodbridge, VA 22192 | 2017-09-14 |
| 1992226344 | Arm Baby Eldery Home Health LLC | Home Health | 13000 Harbor Center Dr # 312c, Woodbridge, VA 22192 | 2017-07-06 |
| Find all providers in zip 22192 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588056139 | Lifelong Good Health LLC | Clinic/Center | 5721 Rhode Isalnd Drive, Woodbridge, VA 22193 | 2015-02-19 |
| 1447651070 | Community Visions LLC | Clinic/Center | 4491 Cheshire Station Plz, Woodbridge, VA 22193-2226 | 2014-09-15 |
| 1720212103 | Mankooei Chiropractic Center 2, LLC | Clinic/Center | 4328 Dale Blvd, Woodbridge, VA 22193-2402 | 2009-05-13 |
| 1073550505 | My Urgent Care PC | Clinic/Center | 14527 Jefferson Davis Hwy, Woodbridge, VA 22191-2817 | 2006-06-01 |
| 1588654990 | Department of Defense | Clinic/Center | 14450 Smoketown Rd, Woodbridge, VA 22192-4712 | 2005-10-26 |
| 1942662259 | Tms Neurohealth Centers Woodbridge LLC | Clinic/Center | 13649 Office Pl, Suite 102, Woodbridge, VA 22192-4215 | 2016-03-25 |
| 1013372366 | Woodbridge Infertility Institute | Clinic/Center | 14904 Jefferson Davis Hwy, Davis Highway, Woodbridge, VA 22191-3908 | 2015-12-30 |
| 1669629424 | Dr-al Family and Urgent Care, Plc | Clinic/Center | 14914 Jefferson Davis Hwy, Woodbridge, VA 22191-4016 | 2008-08-25 |
| 1073799177 | Kevin Nguyen Dds Pllc | Clinic/Center | 14130 Noblewood Plz, 207, Woodbridge, VA 22193-1464 | 2008-01-18 |
| 1811922370 | Shriharsh Pole, Md PC | Clinic/Center | 14904 Jefferson Davis Hwy, Suite 205, Woodbridge, VA 22191-3908 | 2006-07-12 |
| Find all providers in WOODBRIDGE | ||||
| City | WOODBRIDGE |
| Zip Code | 22192 |
Please comment or provide details below to improve the information on DENTAL CENTER @ LAKE RIDGE.
| 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.