MEDICARE: AMANDA A. HOOVER DENTAL PC

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

General Provider Information

NPI Number	:	1467103200
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMANDA A. HOOVER DENTAL PC

Provider Business Mailing Address
First Line	:	6043 HARBOUR PARK DR
Second Line	:
City	:	MIDLOTHIAN
State	:	VA
Zip	:	23112-2160
Country	:	US
Telephone Number	:	804-739-8287
Fax Number	:

Provider Business Practice Location Address
First Line	:	6043 HARBOUR PARK DR
Second Line	:
City	:	MIDLOTHIAN
State	:	VA
Zip	:	23112-2160
Country	:	US
Telephone Number	:	804-739-8287
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATIVE ASSISTANT
Name	:	MRS. LAURI HENDERSON
Credential	:
Telephone Number	:	804-897-3600

Provider Enumeration Date	:	01/13/2022
Last Update Date	:	02/16/2026

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