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General NPI Number Information
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NPI Number | 1538792197
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Entity Type | Individual
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Provider Name | VIVEK NARRA
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Gender | Male
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Dates
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Enumeration Date | 02/21/2020
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Last Update Date | 02/21/2020
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Provider Practice Location Address
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Address Line | 2040 COLISEUM DR
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City | HAMPTON
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State | VA
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Zip | 23666-3200
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Country | US
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Telephone | 757-262-0020
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Fax |
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Provider Business Mailing Address
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Address Line | 6343 TOWNSHIP ROAD 136
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City | FINDLAY
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State | OH
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Zip | 45840-9675
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Country | US
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Telephone | 419-819-2214
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 0401416857
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License Number State | VA
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