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General NPI Number Information
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NPI Number | 1528057619
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Entity Type | Individual
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Provider Name | MARIELLA B CONNORS DMD
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Gender | Female
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Dates
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Enumeration Date | 10/20/2005
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 6224 PORTSMOUTH BLVD STE 300
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City | PORTSMOUTH
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State | VA
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Zip | 23701-1351
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Country | US
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Telephone | 757-500-8500
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Fax |
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Provider Business Mailing Address
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Address Line | 2124 BIERCE DR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-7217
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Country | US
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Telephone | 857-654-2321
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DEN.00205516
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 20376
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 0401418346
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License Number State | VA
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