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Contact Information

SOUTHSIDE ENDODONTICS, PC
2425 BOULEVARD
SUITE 8
COLONIAL HEIGHTS, VA23834-2324
 Phone: 804-520-0000
 Fax: 804-520-2111
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Endodontics

1223E0200X
Indicates primary specialty

NPI Profile & details for SOUTHSIDE ENDODONTICS, PC

NPI Number 1053494260
LBN Legal business name SOUTHSIDE ENDODONTICS, PC
Authorized official ELLEN OERTEL - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/23/2006
Last updated 03/06/2009 - About 17 years ago
Identifiers
VA License # 401007706
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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