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Deactivated NPI 1710996244 Deactivated / Inactive NPI Male Practitioner

Dr. David R Tebbenkamp , DDS

Dentist - General Practice • Damascus, VA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. David Tebbenkamp has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 05, 2006
NPI Deactivation Date December 11, 2018
Total Practice Duration ~12 Years of Practice (2006 – 2018)

Professional Overview & Biography Verified Profile Summary

Dr. David Tebbenkamp, DDS was a registered Dentist - General Practice practicing in Damascus, VA. Throughout an active medical career spanning 12 years, Dr. Tebbenkamp provided care at the practice location at 21788 AZEN RD until profile deactivation on 2018-12-11.

Practice Location & Contact Primary Location

Practice Address

21788 Azen Rd

Damascus, VA 242364236

Telephone 2763883511
Fax 2763883163
Associated Practice Facility / Clinic
🏢 David R. Tebbenkamp Dds Pc Facility NPI 1114127537

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Damascus, VA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 14.6 Yrs
Regional Practice Density
1 Specialists

Practicing in Damascus, VA (3535 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License VA 0401004941

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated December 11, 2018

Record deactivated on December 11, 2018

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 21788 AZEN RD, DAMASCUS, VA 242364236 (Tel: 2763883511)

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Updated Business Mailing Address July 08, 2007

Registered at 21788 AZEN RD, DAMASCUS, VA 242364236 (Tel: 2763883511)

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Provider Name / Credentials Updated July 08, 2007

Recorded as DAVID TEBBENKAMP, DDS

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #0401004941 in VA)

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Initial NPI Registration & Enumeration August 05, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1710996244
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 05, 2006
Last Update: July 08, 2007
Deactivation Date: December 11, 2018

Mailing Address

21788 Azen Rd

Damascus, VA 242364236

Phone: 2763883511

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.