MEDICARE: LUIS ANGEL MEZA CONTRERAS 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
1	1223G0001X	General Practice Dentistry	0401420048	VA

General Provider Information

NPI Number	:	1760314116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUIS ANGEL MEZA CONTRERAS DMD

Provider Business Mailing Address
First Line	:	100 QUIN W STUART BLVD NW
Second Line	:
City	:	CHRISTIANSBURG
State	:	VA
Zip	:	24073-1383
Country	:	US
Telephone Number	:	571-222-5419
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 QUIN W STUART BLVD NW
Second Line	:
City	:	CHRISTIANSBURG
State	:	VA
Zip	:	24073-1383
Country	:	US
Telephone Number	:	571-222-5419
Fax Number	:

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

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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