Provider Demographics
NPI:1235245200
Name:COALTER, EARNEST DEAN JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:EARNEST
Middle Name:DEAN
Last Name:COALTER
Suffix:JR
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 1:933 FIRST COLONIAL RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454
Mailing Address - Country:US
Mailing Address - Phone:757-491-8075
Mailing Address - Fax:757-422-4236
Practice Address - Street 1:17068 LANKFORD HIGHWAY
Practice Address - Street 2:
Practice Address - City:EASTVILLE
Practice Address - State:VA
Practice Address - Zip Code:23347
Practice Address - Country:US
Practice Address - Phone:757-331-1086
Practice Address - Fax:757-442-9505
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010053231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
184089OtherUCCI INS