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Contact Information

COSMETIC DENTISTRY
931 PROVIDENCE RD
CHESAPEAKE, VA23325-4200
 Phone: 757-366-0330
 Fax: 757-366-0550
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Preferred Provider Organization

305R00000X
Indicates primary specialty

NPI Profile & details for COSMETIC DENTISTRY

NPI # 1134671514
LBN Legal business name COSMETIC DENTISTRY
Authorized official TAYLOR HICKMAN - (OFFICE ASSISTANT)
Entity Organization
Organization subpart 1 No
Enumeration date 11/01/2016
Last updated 11/01/2016 - About 10 years ago
Identifiers
VA License # 0401411210
VA Other 1649318247 NPI
VA Other 1992010953 THAMES NPI
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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