1407030323 NPI number — RHEA DAVIS, DDS & ARSHIA SHINGLER, DDS, PC

Table of content: (NPI 1407030323)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407030323 NPI number — RHEA DAVIS, DDS & ARSHIA SHINGLER, DDS, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RHEA DAVIS, DDS & ARSHIA SHINGLER, DDS, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1407030323
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/27/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7534 LIMESTONE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GAINESVILLE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
20155-4005
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-754-1580
Provider Business Mailing Address Fax Number:
703-754-1897

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7534 LIMESTONE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GAINESVILLE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
20155-4005
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-754-1580
Provider Business Practice Location Address Fax Number:
703-754-1897
Provider Enumeration Date:
12/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PERRY
Authorized Official First Name:
TINA
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
703-754-1580

Provider Taxonomy Codes

  • Taxonomy code: 1223P0221X , with the licence number:  0401410803 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1223P0221X , with the licence number: 0401410642 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 10642 . This is a "DELTA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 107236 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9178837 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 186586 . This is a "BCBS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1580984 . This is a "UNITED CONCORDIA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 9179290 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10803 . This is a "DELTA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1753242 . This is a "UNITED CONCORDIA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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