VA Southern Dental PPO PC
NPI 1053293746ActiveOrganization· Dentist· Fredericksburg, VA
Dentist in Fredericksburg, Virginia, registered in NPPES in July 2025, part of VA Southern Dental PPO PC. The authorized official on file is Erika Melissa Menjivar, Sr. Credentialing Specialist.
Overview
| NPI | 1053293746 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | VA Southern Dental PPO PC |
| NPI issued | Jul 23, 2025 |
| Last updated in NPPES | Jul 23, 2025 |
| Certified by provider | Jul 23, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist Primary | 122300000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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