# CHARLOTTESVILLE BLUE RIDGE DENTAL, PLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538849880
- **Authorized official:** JESSICA HUNTER (DIRECTOR OF NETWORK RELATIONS)
- **Authorized official phone:** (704) 780-4597

## Contact information

- **Practice address:** 2320 COMMONWEALTH DR, CHARLOTTESVILLE, VA 22901-1622
- **Practice address phone:** (434) 978-1510
- **Practice address fax:** (434) 978-2857
- **Mailing address:** 19810 W CATAWBA AVE STE A1, CORNELIUS, NC 28031-4056
- **Mailing address phone:** (704) 997-8878

## Taxonomy

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

## Other

- **Enumeration date:** 07/21/2023
- **Last updated:** 04/09/2026