MEDICARE: DR. LUIZ HENRIQUE MARTINS ASSUNCAO

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
1	1223G0001X	General Practice Dentistry	0401419704	VA

General Provider Information

NPI Number	:	1699518571
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LUIZ HENRIQUE MARTINS ASSUNCAO

Provider Business Mailing Address
First Line	:	593 RIVANNA HILL RD
Second Line	:
City	:	GLEN ALLEN
State	:	VA
Zip	:	23060-4041
Country	:	US
Telephone Number	:	804-933-4037
Fax Number	:

Provider Business Practice Location Address
First Line	:	3904 HULL STREET RD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23224-1714
Country	:	US
Telephone Number	:	804-233-0007
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2024
Last Update Date	:	01/15/2026

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