Healthcare Provider Details

I. General information

NPI: 1023972346
Provider Name (Legal Business Name): VIRGINIA ANN DOREN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2117 MCCOMAS WAY STE 101
VIRGINIA BEACH VA
23456-3908
US

IV. Provider business mailing address

2117 MCCOMAS WAY STE 101
VIRGINIA BEACH VA
23456-3908
US

V. Phone/Fax

Practice location:
  • Phone: 757-426-6155
  • Fax: 757-426-6803
Mailing address:
  • Phone: 757-426-6155
  • Fax: 757-426-6803

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code126800000X
TaxonomyDental Assistant
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: