OrganizationActive
Jesserwallddspa
NPI 1104090067 · Dentist · Danville, VA
Jesserwallddspa is a Dentist organization in Danville, VA (NPI 1104090067).
Provider details
- NPI number
- 1104090067
- Entity type
- Organization
- Primary specialty
- DentistDental Providers
- Organization subpart
- No
- Authorized official
- Jesse Wall, President(434) 792-1512
- License
- 5098 (VA)
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(87/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1045 Main St
Suite 6
Danville, VA 24541-1800
Phone: (434) 792-8622
Street-level locationGet directions
Mailing address
1045 Main St
Danville, VA 24541-1800
Registry dates
- Enumerated
- 2008-04-22
- Last updated
- 2008-04-22
Frequently asked questions
- What is Jesserwallddspa's NPI number?
- Jesserwallddspa's National Provider Identifier (NPI) is 1104090067, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Jesserwallddspa?
- Jesserwallddspa is classified in the NPPES registry as Dentist (Dental Providers).
- Where is Jesserwallddspa located?
- Jesserwallddspa's practice location on file with NPPES is 1045 Main St, Danville, VA 24541-1800.
- What is Jesserwallddspa's phone number?
- The practice phone number listed in the NPPES registry for Jesserwallddspa is (434) 792-8622.
- Who is the authorized official for Jesserwallddspa?
- The authorized official listed on Jesserwallddspa's NPPES record is Jesse Wall, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Jesserwallddspa's NPI active?
- Yes — Jesserwallddspa's NPI (1104090067) is active in the NPPES registry as of the last update on 2008-04-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.