# COMMONWEALTH PEDIATRIC DENTAL SPECIALISTS

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

## Provider details

- **NPI number:** 1679978795
- **Authorized official:** DR. JOY PHELPS D.M.D. (PEDIATRIC DENTIST/OWNER)
- **Authorized official phone:** (617) 875-6808

## Contact information

- **Practice address:** 5506 WHITESIDE ROAD, SANDSTON, VA 23150-2345
- **Practice address phone:** (617) 875-6808
- **Mailing address:** 5506 WHITESIDE ROAD, SANDSTON, VA 23150-2345
- **Mailing address phone:** (617) 875-6808

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 401411512 | VA | Yes |

## Other

- **Enumeration date:** 10/31/2014
- **Last updated:** 10/31/2014