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General NPI Number Information
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NPI Number | 1093663411
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Entity Type | Organization
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Legal Business Name | GOS CHESAPEAKE PLLC
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Dates
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Enumeration Date | 03/20/2026
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Last Update Date | 03/20/2026
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Provider Practice Location Address
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Address Line | 1100 VOLVO PKWY STE 300
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City | CHESAPEAKE
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State | VA
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Zip | 23320-3341
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Country | US
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Telephone | 757-819-7002
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Fax |
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Provider Business Mailing Address
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Address Line | 837 FIRST COLONIAL RD
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City | VIRGINIA BEACH
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State | VA
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Zip | 23451-6195
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Country | US
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Telephone | 757-412-2002
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SCOTT R GOODOVE
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Credential | DDS
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Telephone | 757-412-2002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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