Healthcare Provider Details

I. General information

NPI: 1134050990
Provider Name (Legal Business Name): ISABEL BIRKELAND DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4119 BRANDON AVE SW
ROANOKE VA
24018-1203
US

IV. Provider business mailing address

4943 LAKE AVE
WHITE BEAR LAKE MN
55110-2627
US

V. Phone/Fax

Practice location:
  • Phone: 540-776-6555
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number0401420007
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: