1841646304 NPI number — VALLEY DENTAL CARE

Table of content: MOLLY SUSANNE HEMENWAY PNP (NPI 1801974167)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841646304 NPI number — VALLEY DENTAL CARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VALLEY DENTAL CARE
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:
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:
1841646304
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/13/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
563 JAMES MADISON HWY
Provider Second Line Business Mailing Address:
102
Provider Business Mailing Address City Name:
CULPEPER
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22701-2365
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-827-4076
Provider Business Mailing Address Fax Number:
540-431-2728

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
563 JAMES MADISON HWY
Provider Second Line Business Practice Location Address:
102
Provider Business Practice Location Address City Name:
CULPEPER
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22701-2365
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-827-4076
Provider Business Practice Location Address Fax Number:
540-431-2728
Provider Enumeration Date:
05/13/2016

Additional Information

Authorized Official

Authorized Official Last Name:
THIEM
Authorized Official First Name:
TAMMY
Authorized Official Middle Name:
Authorized Official Title or Position:
GENERAL MANAGER
Authorized Official Telephone Number:
540-827-4076

Provider Taxonomy Codes

  • Taxonomy code: 261QD0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com