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Contact Information

JEFFREY D DOMARK, DMD, MS
1550 TOMCAT BLVD
SUITE 150
VIRGINIA BEACH, VA23460-2188
 Phone: 757-953-3926
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
 

Endodontics

1223E0200X
Indicates primary specialty

NPI Profile & details for JEFFREY D DOMARK · (Male)

NPI Number 1336119528
Status Active
Credentials DMD, MS
Entity Individual
Enumeration date 01/23/2006
Last updated 12/09/2011 - About 14 years ago
Sole proprietor 1 Yes
Identifiers
  • IL License # 019-026178
  • MO License # 2010010741
  • VA License # 0401413366
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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