MEDICARE: GAIL V. PLAUKA, D.M.D., P.C.

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	1223P0221X	Pediatric Dentistry	0401006218	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437216959
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GAIL V. PLAUKA, D.M.D., P.C.

Provider Business Mailing Address
First Line	:	350 JOHNSTOWN RD
Second Line	:	SUITE C
City	:	CHESAPEAKE
State	:	VA
Zip	:	23322-5365
Country	:	US
Telephone Number	:	757-482-4777
Fax Number	:

Provider Business Practice Location Address
First Line	:	350 JOHNSTOWN RD
Second Line	:	SUITE C
City	:	CHESAPEAKE
State	:	VA
Zip	:	23322-5365
Country	:	US
Telephone Number	:	757-482-4777
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. JORDANA EFLAND
Credential	:
Telephone Number	:	757-482-4777

Provider Enumeration Date	:	01/03/2007
Last Update Date	:	08/22/2020

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