MEDICARE: ICON PEDIATRIC DENTISTRY AND ORTHODONTICS PLLC

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	122300000X	Dentist

General Provider Information

NPI Number	:	1427903038
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ICON PEDIATRIC DENTISTRY AND ORTHODONTICS PLLC

Provider Business Mailing Address
First Line	:	125 INDEPENDENCE BLVD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-6705
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	142 INDEPENDENCE BLVD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-6718
Country	:	US
Telephone Number	:	757-471-2900
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. YUGAL BEHL
Credential	:
Telephone Number	:	757-224-3004

Provider Enumeration Date	:	02/27/2026
Last Update Date	:	03/11/2026

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