Provider Demographics
NPI:1013575661
Name:IRBY DENTISTRY
Entity Type:Organization
Organization Name:IRBY DENTISTRY
Other - Org Name:IRBY & RAMSEY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:IRBY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:434-294-2647
Mailing Address - Street 1:3501 FRANKLIN RD SW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24014-2201
Mailing Address - Country:US
Mailing Address - Phone:540-342-6800
Mailing Address - Fax:
Practice Address - Street 1:3501 FRANKLIN RD SW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24014-2201
Practice Address - Country:US
Practice Address - Phone:540-342-6800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-30
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0401415511OtherDENTAL LICENSE NUMBER