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NPI Code Detail

MEDICARE: DR. JOSEPH JUSTIN BOOTH DMD

MEDICARE: DR. JOSEPH JUSTIN BOOTH DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry0401418925VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1184816936
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSEPH JUSTIN BOOTH DMD
Provider Business Mailing Address
First Line : 11846 PERDUE SPRINGS CT
Second Line :
City : CHESTER
State : VA
Zip : 23831-2164
Country : US
Telephone Number : 512-784-9961
Fax Number :
Provider Business Practice Location Address
First Line : 11846 PERDUE SPRINGS CT
Second Line :
City : CHESTER
State : VA
Zip : 23831-2164
Country : US
Telephone Number : 804-906-7555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2007
Last Update Date : 09/29/2025

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Directions to “ DR. JOSEPH JUSTIN BOOTH DMD” Practice Location

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