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NPI Code Detail

MEDICARE: DR. RICHARD KENNETH QUIGG D.D.S.

MEDICARE: DR. RICHARD KENNETH QUIGG 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
11223S0112XOral and Maxillofacial Surgery (Dentist)0401006635VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1243296OTHERVAANTHEM
2571199OTHERVAUNITED CONCORDIA

General Provider Information

NPI Number : 1932280351
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RICHARD KENNETH QUIGG D.D.S.
Provider Business Mailing Address
First Line : 984 FIRST COLONIAL RD
Second Line : SUITE 300
City : VIRGINIA BEACH
State : VA
Zip : 23454-3196
Country : US
Telephone Number : 757-496-6690
Fax Number : 757-496-6695
Provider Business Practice Location Address
First Line : 984 FIRST COLONIAL RD
Second Line : SUITE 300
City : VIRGINIA BEACH
State : VA
Zip : 23454-3196
Country : US
Telephone Number : 757-496-6690
Fax Number : 757-496-6695
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2006
Last Update Date : 07/08/2007

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