Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Tremont Road Dental Super, PC

Organization Dentist · NPI 1255524120

Tremont Road Dental Super, PC is a Dentist in Woodbridge, Virginia. Licensed in Virginia. Registered with an NPI since 2007.

Licensed in
VA
In the registry since
2007
Specialties on file
4
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2000 Daniel Stuart Sq
Woodbridge, VA 22191-3315
Phone: (770) 916-9000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X
Dentist Taxonomy 122300000X · Licence 0401411091 (VA)
Endodontics Taxonomy 1223E0200X
Oral and Maxillofacial Surgery (Dentist) Taxonomy 1223S0112X

Record details

NPI number1255524120
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michelle Jacomino — Director Of Payor Relations · (770) 916-5036
Other names Pine Dentistry
NPI enumeratedAugust 23, 2007
Last updated in NPPESJanuary 18, 2024
Certification dateJanuary 18, 2024
Mailing address210 Interstate North Pkwy Se Ste 300, Atlanta, GA 30339-2233

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