MEDICARE: PRO DENTAL VA 1, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1740037019
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRO DENTAL VA 1, P.C.

Provider Business Mailing Address
First Line	:	10 WOODBRIDGE CENTER DR STE 520
Second Line	:
City	:	WOODBRIDGE
State	:	NJ
Zip	:	07095-1152
Country	:	US
Telephone Number	:	732-616-0292
Fax Number	:

Provider Business Practice Location Address
First Line	:	6084 SAM SNEAD HWY
Second Line	:
City	:	HOT SPRINGS
State	:	VA
Zip	:	24445-2664
Country	:	US
Telephone Number	:	540-684-3765
Fax Number	:

Authorized Official
Title or Position	:	CONTROLLER
Name	:	MATTHEW RUBINSON
Credential	:
Telephone Number	:	732-616-0292

Provider Enumeration Date	:	05/03/2024
Last Update Date	:	05/03/2024

Similar Medicare Providers

1225123995 — LAURIE A. SARGENT DDS
Practice Location Address:

6084 SAM SNEAD HWY
HOT SPRINGS, VA
24445-2664

Practice Phone: 240-295-3265
Practice Fax: 540-839-2836

1982007852 — ALLEGHANY HIGHLANDS DENTAL CARE, PC
Practice Location Address:

6084 SAM SNEAD HWY
HOT SPRINGS, VA
24445-2664

Practice Phone: 540-839-3500
Practice Fax:

1518201714 — JEFFREY MARCUS ALLEN DMD
Practice Location Address:

6213 WASHINGTON AVE
OCEAN SPRINGS, MS
39564-2664

Practice Phone: 866-924-3649
Practice Fax:

1740995430 — COASTAL DENTURES & IMPLANTS
Practice Location Address:

6213 WASHINGTON AVE
OCEAN SPRINGS, MS
39564-2664

Practice Phone: 228-215-0801
Practice Fax: 228-367-0007

1780423905 — DENTURES & IMPLANTS - OCEAN SPRINGS, LLC
Practice Location Address:

6213 WASHINGTON AVE
OCEAN SPRINGS, MS
39564-2664

Practice Phone: 866-539-3519
Practice Fax:

1073328720 — LASONYA Z JACKSON
Practice Location Address:

175 MORNING SPRINGS WALK
FAYETTEVILLE, GA
30214-2664

Practice Phone: 404-484-4222
Practice Fax:

Directions to “PRO DENTAL VA 1, P.C. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.