DR. ANGEL FERNANDO MOGROVEJO FAJARDO (NPI# 1831532829) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831532829 |
| Entity Type | Individual |
| Full Name | DR. ANGEL FERNANDO MOGROVEJO FAJARDO |
| Credential | DDS, MS |
| Practice Address |
461 Mclaws Cir Ste 1 Williamsburg VA 23185-6350 |
| Practice Telephone | 7572210249 |
| Mailing Telephone | 7572210249 |
| Enumeration Date | 2013-04-10 |
| Last Update Date | 2019-03-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
0401415449 | VA | Dental Providers |
| Street Address |
461 MCLAWS CIR STE 1 |
| City | WILLIAMSBURG |
| State | VA |
| Zip Code | 23185-6350 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215579412 | Marian Shearin | Technician | 112 Indian Circle, Williamsburg, VA 23185 | 2019-10-09 |
| 1093363251 | 1st Choice In-homecare, Inc. | Durable Medical Equipment & Medical Supplies | 161-a John Jefferson Road Ste 101, Williamsburg, VA 23185 | 2019-08-30 |
| 1265939482 | Michelle Antionette Hill | Counselor | 1769 Jamestown Rd Ste 107, Williamsburg, VA 23185 | 2018-04-13 |
| 1114437480 | Kimberly Anne Allan | Orthotic Fitter | 1811 Jamestown Rd., Williamsburg, VA 23185 | 2017-10-02 |
| 1881115590 | Shawn Patrick Mcnulty | Counselor | Colonial Behavioral Health, 1657 Merrimac Trail, Williamsburg, VA 23185 | 2017-07-03 |
| 1790215986 | Sea Change Therapy Pllc | Community/Behavioral Health | 3308 Ash Vw, Williamsburg, VA 23185 | 2017-06-19 |
| 1316479322 | Maureen Bounds | Pharmacist | 230 Gooch Dr, Williamsburg, VA 23185 | 2017-03-29 |
| 1386196970 | Joshua Desilva | Psychologist | 240 Gooch Drive, 2nd Floor, Williamsburg, VA 23185 | 2016-10-29 |
| 1750837001 | Ellen Lerose | Pharmacist | 5601-b Richmond Road, Williamsburg, VA 23185 | 2016-08-28 |
| 1194173922 | Michael C. Shuck, Dds PC | Dentist | 1480 Quarterpath Rd, Ste 2a, Williamsburg, VA 23185 | 2016-06-02 |
| Find all providers in zip 23185 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992825657 | Michael Schroer | Dentist | 200 Packets Ct, Williamsburg, VA 23185-5629 | 2007-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497361471 | Lisa A. Marvil, D.m.d., P.l.l.c. | Dentist | 17341-b Pickwick Drive, Purcellville, VA 20132 | 2020-09-16 |
| 1720624307 | Deena Hadithi Dmd, PC. | Dentist | 7210 Old Keene Mill Rd Ste 3, Springfield, VA 22150-3442 | 2019-11-19 |
| 1689223836 | Alka Panwar | Dentist | 4319 Dale Blvd Ste 6, Woodbridge, VA 22193-2401 | 2019-09-10 |
| 1801445135 | Neha Agarwal | Dentist | 23386 Epperson Sq, Brambleton, VA 20148-5794 | 2019-09-09 |
| 1164999181 | Smba Dentistry, Pllc | Dentist | 2801 Mcrae Rd Ste C1, North Chesterfield, VA 23235-3056 | 2018-10-29 |
| 1750860516 | Khashayar Kordbacheh Changi | Dentist | 3543 W Braddock Rd Ste E2, Alexandria, VA 22302-1903 | 2018-08-11 |
| 1205314309 | Shivangi B Amin | Dentist | 2420 Old Brick Rd Apt 1315, Glen Allen, VA 23060-5995 | 2018-07-31 |
| 1881107100 | New River Periodontics and Dental Implant Center, PC | Dentist | 2612 Sheffield Drive, Blacksburg, VA 24060 | 2017-11-08 |
| 1740793355 | Amy Ton Dds Pllc | Dentist | 11868 Sunrise Valley Dr Ste 100, Reston, VA 20191-3320 | 2017-11-06 |
| 1023539301 | Denver James Lyons | Dentist | 521 N 11th St # 980566, Richmond, VA 23298-5045 | 2017-06-27 |
| Find all providers with the same taxonomy | ||||
| City | WILLIAMSBURG |
| Zip Code | 23185 |
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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.