MEDICARE: DR. ELMER LEONARD REAVES JR. D.D.S.

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	1223D0001X	Public Health Dentistry	0401005262	VA

General Provider Information

NPI Number	:	1780674879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELMER LEONARD REAVES JR. D.D.S.

Provider Business Mailing Address
First Line	:	1304 BRADDOCK AVE
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23455-4102
Country	:	US
Telephone Number	:	757-363-9568
Fax Number	:

Provider Business Practice Location Address
First Line	:	1320 LASALLE AVE
Second Line	:
City	:	HAMPTON
State	:	VA
Zip	:	23669-3801
Country	:	US
Telephone Number	:	757-727-2585
Fax Number	:	757-727-4881

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

Provider Enumeration Date	:	10/28/2005
Last Update Date	:	07/08/2007

Similar Medicare Providers

1407971864 — VIRGINIA DEPARTMENT OF HEALTH
Practice Location Address:

1320 LASALLE AVE
HAMPTON, VA
23669-3801

Practice Phone: 757-727-1140
Practice Fax:

1245478221 — HAMPTON ROADS ECUMENICAL LODGINGS AND PROVISIONS, INC.
Practice Location Address:

1320 LASALLE AVE
HAMPTON, VA
23669-3801

Practice Phone: 757-727-2577
Practice Fax: 757-723-0469

1245523638 — MISS NINA LATASHA JERNIGAN FNP
Practice Location Address:

1320 LASALLE AVE
HAMPTON, VA
23669-3801

Practice Phone: 757-727-1820
Practice Fax:

1366433443 — NATALIE ADDINGTON BARRON MD
Practice Location Address:

191 FOX HILL RD , SUITE D
HAMPTON, VA
23669-2360

Practice Phone: 757-850-1311
Practice Fax: 757-850-7315

1184615262 — DEBRA BOYER MD
Practice Location Address:

191 FOX HILL RD , SUITE D
HAMPTON, VA
23669-2360

Practice Phone: 757-850-1311
Practice Fax: 757-850-7315

1902884901 — DR. MICHAEL JEFFERIES M.D.
Practice Location Address:

112 PINE CREEK DR
HAMPTON, VA
23669-1244

Practice Phone: 757-810-3232
Practice Fax: 757-788-8816

Directions to “ DR. ELMER LEONARD REAVES JR. D.D.S.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.