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General NPI Number Information
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NPI Number | 1467008250
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Entity Type | Organization
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Legal Business Name | CHESAPEAKE DENTAL SPECIALISTS PLLC
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Dates
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Enumeration Date | 08/16/2019
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Last Update Date | 08/16/2019
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Provider Practice Location Address
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Address Line | 560 KEMPSVILLE RD SUITE 201
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City | CHESAPEAKE
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State | VA
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Zip | 23320
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Country | US
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Telephone | 757-378-0906
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Fax | 757-350-8820
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Provider Business Mailing Address
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Address Line | 560 KEMPSVILLE RD SUITE 201
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City | CHESAPEAKE
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State | VA
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Zip | 23320
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Country | US
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Telephone | 757-378-0906
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Fax | 757-350-8820
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | KATIE J ROBINSON
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Credential |
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Telephone | 757-378-0906
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number |
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License Number State |
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