MEDICARE: DR. ERIC R CAPPS 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
1	122300000X	Dentist	0401006771	VA
2	1223G0001X	General Practice Dentistry	0401006771	VA

General Provider Information

NPI Number	:	1639338510
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC R CAPPS DDS

Provider Business Mailing Address
First Line	:	836 FIRST COLONIAL RD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-6126
Country	:	US
Telephone Number	:	757-428-8747
Fax Number	:	757-422-8165

Provider Business Practice Location Address
First Line	:	836 FIRST COLONIAL RD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-6126
Country	:	US
Telephone Number	:	757-428-8747
Fax Number	:	757-422-8165

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

Provider Enumeration Date	:	06/05/2008
Last Update Date	:	03/28/2022

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