Healthcare Provider Details

I. General information

NPI: 1629884663
Provider Name (Legal Business Name): DONTE LAMPLEY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2024
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

776 OAK GROVE RD
CHESAPEAKE VA
23320-3728
US

IV. Provider business mailing address

776 OAK GROVE RD
CHESAPEAKE VA
23320-3728
US

V. Phone/Fax

Practice location:
  • Phone: 757-354-2885
  • Fax: 757-917-5141
Mailing address:
  • Phone: 757-354-2885
  • Fax: 757-917-5141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110012064
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: