Healthcare Provider Details

I. General information

NPI: 1669630430
Provider Name (Legal Business Name): ADAM MICHAEL POOLE D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2008
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4239 HOLLAND RD SUITE 762-A
VIRGINIA BEACH VA
23452-1941
US

IV. Provider business mailing address

517 24 1/2 ST
VIRGINIA BEACH VA
23451-4054
US

V. Phone/Fax

Practice location:
  • Phone: 757-465-5665
  • Fax:
Mailing address:
  • Phone: 757-802-1628
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number0401412212
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: