Healthcare Provider Details

I. General information

NPI: 1619260312
Provider Name (Legal Business Name): ADAM BECKER D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2011
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 LYNNHAVEN PKWY STE 170
VIRGINIA BEACH VA
23452-7339
US

IV. Provider business mailing address

621 LYNNHAVEN PKWY STE 170
VIRGINIA BEACH VA
23452-7339
US

V. Phone/Fax

Practice location:
  • Phone: 757-200-6222
  • Fax: 757-200-6224
Mailing address:
  • Phone: 757-200-6222
  • Fax: 757-200-6224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number0401413714
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: