Healthcare Provider Details

I. General information

NPI: 1134934508
Provider Name (Legal Business Name): SAGE ELIZABETH PANKEY DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2025
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7450 RICHMOND RD
WILLIAMSBURG VA
23188-7223
US

IV. Provider business mailing address

7450 RICHMOND RD
WILLIAMSBURG VA
23188-7223
US

V. Phone/Fax

Practice location:
  • Phone: 540-815-1553
  • Fax:
Mailing address:
  • Phone: 757-564-0804
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number0401419444
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: