# DENTAL PROFESSIONALS OF VIRGINIA, P.C

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

## Provider details

- **NPI number:** 1104253186
- **Legal business name:** DENTAL PROFESSIONALS OF VIRGINIA, P.C
- **Authorized official:** LINDSAY BEARDEN (INSURANE/CREDENTIALING)
- **Authorized official phone:** (217) 540-5100

## Contact information

- **Practice address:** 43170 SOUTHERN WALK PLZ, SUITE 116, BROADLANDS, VA 20148-4464
- **Practice address phone:** (703) 957-7066
- **Mailing address:** 43170 SOUTHERN WALK PLZ, SUITE 116, BROADLANDS, VA 20148-4464
- **Mailing address phone:** (703) 957-7066

## Taxonomy

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

## Other

- **Enumeration date:** 10/04/2013
- **Last updated:** 01/11/2014