Healthcare Provider Details

I. General information

NPI: 1407303084
Provider Name (Legal Business Name): DAVID CARLTON DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2016
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4701 COLUMBUS ST STE 105
VIRGINIA BEACH VA
23462-6725
US

IV. Provider business mailing address

4701 COLUMBUS ST STE 105
VIRGINIA BEACH VA
23462-6725
US

V. Phone/Fax

Practice location:
  • Phone: 757-473-5706
  • Fax:
Mailing address:
  • Phone: 757-473-5706
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number0401415366
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: