Healthcare Provider Details

I. General information

NPI: 1982523593
Provider Name (Legal Business Name): DENTAL PROFESSIONALS OF VIRGINIA, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

491 MCLAWS CIR STE 1
WILLIAMSBURG VA
23185-6342
US

IV. Provider business mailing address

491 MCLAWS CIR STE 1
WILLIAMSBURG VA
23185-6342
US

V. Phone/Fax

Practice location:
  • Phone: 757-253-0598
  • Fax:
Mailing address:
  • Phone: 757-253-0598
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: CEMYIRA MCDOUGAL
Title or Position: CRED COORDINATOR
Credential:
Phone: 217-764-8609