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NPI Code Detail

MEDICARE: LDG - VIRGINIA BEACH, PLLC

MEDICARE: LDG - VIRGINIA BEACH, PLLC
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 Dentistry

General Provider Information

NPI Number : 1811873730
Entity Type Code : Organization
Provider Name (Legal Business Name) : LDG - VIRGINIA BEACH, PLLC
Provider Business Mailing Address
First Line : 2521 N LANDING RD STE 100
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23456-3460
Country : US
Telephone Number : 757-430-9448
Fax Number :
Provider Business Practice Location Address
First Line : 2521 N LANDING RD STE 100
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23456-3460
Country : US
Telephone Number : 757-430-9448
Fax Number :
Authorized Official
Title or Position : CREDENTIALING
Name : CHAD HENDRICKS
Credential :
Telephone Number : 612-859-0444
Provider Enumeration Date : 08/14/2025
Last Update Date : 08/14/2025

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Directions to “LDG - VIRGINIA BEACH, PLLC ” Practice Location

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