# DENTAL PROFESSIONALS OF VIRGINIA, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** DENTAL PROFESSIONALS OF VIRGINIA, P.C.
- **Other names:** Ridgefield Village Dental Care
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1063167039
- **Legal business name:** DENTAL PROFESSIONALS OF VIRGINIA, P.C.
- **Authorized official:** CELIA HAYES (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (217) 540-2100

## Contact information

- **Practice address:** 12707 RIDGEFIELD VILLAGE DR STE 101, WOODBRIDGE, VA 22193-8915
- **Practice address phone:** (571) 989-6570
- **Mailing address:** 12707 RIDGEFIELD VILLAGE DR STE 101, WOODBRIDGE, VA 22193-8915
- **Mailing address phone:** (571) 989-6570

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 02/17/2022
- **Last updated:** 02/17/2022