Healthcare Provider Details

I. General information

NPI: 1700706959
Provider Name (Legal Business Name): LYNNHAVEN DENTAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

609 LYNNHAVEN PKWY
VIRGINIA BEACH VA
23452-7336
US

IV. Provider business mailing address

609 LYNNHAVEN PKWY
VIRGINIA BEACH VA
23452-7336
US

V. Phone/Fax

Practice location:
  • Phone: 757-340-8852
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. AMRISH PATEL
Title or Position: OWNER
Credential: DMD
Phone: 973-610-6026