MEDICARE: MIRPANAH & FAZEL DENTAL

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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1912849795
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIRPANAH & FAZEL DENTAL

Provider Business Mailing Address
First Line	:	9626 21ST BAY ST
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23518-1609
Country	:	US
Telephone Number	:	703-650-8265
Fax Number	:

Provider Business Practice Location Address
First Line	:	984 FIRST COLONIAL RD STE 200
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-3196
Country	:	US
Telephone Number	:	757-412-2235
Fax Number	:

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. JACOB MIRPANAH
Credential	:	DDS, MS
Telephone Number	:	703-650-8265

Provider Enumeration Date	:	04/08/2026
Last Update Date	:	04/08/2026

Similar Medicare Providers

1356397566 — RICHARD B ABRISS M.D.
Practice Location Address:

984 FIRST COLONIAL RD , SUITE 302
VIRGINIA BEACH, VA
23454-3196

Practice Phone: 757-481-0385
Practice Fax: 757-481-6946

1619902988 — DR. CAROL F MORGAN DDS
Practice Location Address:

984 FIRST COLONIAL RD STE 101
VIRGINIA BEACH, VA
23454-3196

Practice Phone: 757-412-1400
Practice Fax:

1821178047 — SCOTT R MORIN M.D.
Practice Location Address:

984 FIRST COLONIAL RD , SUITE 302
VIRGINIA BEACH, VA
23454-3196

Practice Phone: 757-481-0385
Practice Fax: 757-481-6946

1497835615 — COASTAL EAR NOSE AND THROAT SURGEONS
Practice Location Address:

984 FIRST COLONIAL RD , SUITE 302
VIRGINIA BEACH, VA
23454-3196

Practice Phone: 757-481-0385
Practice Fax: 757-481-6946

1932280351 — DR. RICHARD KENNETH QUIGG D.D.S.
Practice Location Address:

984 FIRST COLONIAL RD , SUITE 300
VIRGINIA BEACH, VA
23454-3196

Practice Phone: 757-496-6690
Practice Fax: 757-496-6695

1841364056 — CLAIRE J DOWLING AU.D.
Practice Location Address:

984 FIRST COLONIAL RD , SUITE 302
VIRGINIA BEACH, VA
23454-3196

Practice Phone: 757-481-0385
Practice Fax: 757-481-6946

Directions to “MIRPANAH & FAZEL DENTAL ” 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.