MEDICARE: DR. DAVID WILLIAM SCHONBRUN D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	0401007611	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0401007611	OTHER	VA	LISCENSE
2	017812	OTHER	VA	ANTHEM

General Provider Information

NPI Number	:	1134224785
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID WILLIAM SCHONBRUN D.D.S.

Provider Business Mailing Address
First Line	:	4529 E HONEYGROVE RD
Second Line	:	SUITE 301
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23455-6087
Country	:	US
Telephone Number	:	757-460-1234
Fax Number	:	757-464-2524

Provider Business Practice Location Address
First Line	:	4529 E HONEYGROVE RD
Second Line	:	SUITE 301
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23455-6087
Country	:	US
Telephone Number	:	757-460-1234
Fax Number	:	757-464-2524

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. DAVID WILLIAM SCHONBRUN D.D.S.” Practice Location

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