Provider Demographics
NPI:1053674697
Name:BATISTAS,CHEHADE,DAVENPORT,PLLC
Entity Type:Organization
Organization Name:BATISTAS,CHEHADE,DAVENPORT,PLLC
Other - Org Name:SMILEZ PEDIATRIC DENTAL GROUP
Other - Org Type:Other Name
Authorized Official - Title/Position:C.O.O.
Authorized Official - Prefix:
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-754-7151
Mailing Address - Street 1:7521 VIRGINIA OAKS DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-3831
Mailing Address - Country:US
Mailing Address - Phone:703-754-7151
Mailing Address - Fax:703-754-1694
Practice Address - Street 1:7521 VIRGINIA OAKS DR
Practice Address - Street 2:SUITE 110
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-3831
Practice Address - Country:US
Practice Address - Phone:703-754-7151
Practice Address - Fax:703-754-1694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-19
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty