Provider Demographics
NPI:1144613225
Name:B DAVID BREININGER, DDS PC
Entity Type:Organization
Organization Name:B DAVID BREININGER, DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BYRON
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:BREININGER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:757-467-9622
Mailing Address - Street 1:1453 KEMPSVILLE RD
Mailing Address - Street 2:SUITE #104
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-7319
Mailing Address - Country:US
Mailing Address - Phone:757-467-9622
Mailing Address - Fax:757-467-6920
Practice Address - Street 1:1453 KEMPSVILLE RD
Practice Address - Street 2:SUITE #104
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-7319
Practice Address - Country:US
Practice Address - Phone:757-467-9622
Practice Address - Fax:757-467-6920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-12
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401008404261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center