MEDICARE: ANGELA DENT LPN

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	164W00000X	Licensed Practical Nurse	0002104899	VA

General Provider Information

NPI Number	:	1194652701
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA DENT LPN

Provider Business Mailing Address
First Line	:	4612 STONEY CREEK PKWY
Second Line	:
City	:	CHESTER
State	:	VA
Zip	:	23831-6739
Country	:	US
Telephone Number	:	956-975-0139
Fax Number	:

Provider Business Practice Location Address
First Line	:	4612 STONEY CREEK PKWY
Second Line	:
City	:	CHESTER
State	:	VA
Zip	:	23831-6739
Country	:	US
Telephone Number	:	956-975-0139
Fax Number	:

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

Provider Enumeration Date	:	05/07/2026
Last Update Date	:	05/07/2026

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Directions to “ ANGELA DENT LPN” Practice Location

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