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NPI Code Detail

MEDICARE: DR. EMILY M DIMITROFF DDS

MEDICARE: DR. EMILY M DIMITROFF DDS
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
11223G0001XGeneral Practice Dentistry0401413616VA
21223D0001XPublic Health Dentistry0401413116VA
3122300000XDentist0401413616VA

General Provider Information

NPI Number : 1366704397
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EMILY M DIMITROFF DDS
Provider Business Mailing Address
First Line : 1767 PRINCESS ANNE RD
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23456-3835
Country : US
Telephone Number : 757-426-6151
Fax Number :
Provider Business Practice Location Address
First Line : 1767 PRINCESS ANNE RD
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23456-3835
Country : US
Telephone Number : 757-426-6151
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2012
Last Update Date : 12/31/2025

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Directions to “ DR. EMILY M DIMITROFF DDS” Practice Location

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