Provider Demographics
NPI:1144231481
Name:MAHANES, ALAN W (DDS)
Entity Type:Individual
Prefix:MR
First Name:ALAN
Middle Name:W
Last Name:MAHANES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2521 NORTH LANDING ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456
Mailing Address - Country:US
Mailing Address - Phone:757-430-9448
Mailing Address - Fax:757-427-5121
Practice Address - Street 1:2521 NORTH LANDING ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456
Practice Address - Country:US
Practice Address - Phone:757-430-9448
Practice Address - Fax:757-427-5121
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010068031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice