Healthcare Provider Details

I. General information

NPI: 1346035011
Provider Name (Legal Business Name): FRANK PARET JANE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2025
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 W BRAMBLETON AVE STE 110
NORFOLK VA
23510-1571
US

IV. Provider business mailing address

212 W 31ST ST
NORFOLK VA
23504-1526
US

V. Phone/Fax

Practice location:
  • Phone: 757-583-1536
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number0401420171
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: