Healthcare Provider Details

I. General information

NPI: 1982966628
Provider Name (Legal Business Name): EVA DIMITROVA DENTCHEVA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2012
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 RIVERVIEW AVE STE 400
NORFOLK VA
23510-1065
US

IV. Provider business mailing address

301 RIVERVIEW AVE STE 400
NORFOLK VA
23510-1065
US

V. Phone/Fax

Practice location:
  • Phone: 757-252-1700
  • Fax:
Mailing address:
  • Phone: 757-252-1700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License Number0101272947
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number0101272947
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number0101272947
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: