Healthcare Provider Details

I. General information

NPI: 1518049725
Provider Name (Legal Business Name): DEAN DEARCAS LEMING D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 02/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 CHARLOTTE STREET
TAPPAHANNOCK VA
22560
US

IV. Provider business mailing address

PO BOX 186
TAPPAHANNOCK VA
22560-0186
US

V. Phone/Fax

Practice location:
  • Phone: 804-443-3820
  • Fax: 804-443-3855
Mailing address:
  • Phone: 804-443-3820
  • Fax: 804-443-3855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number0401412012
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number7454
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: