Provider Demographics
NPI:1346884400
Name:ASRA R JAVEED DMD PC
Entity Type:Organization
Organization Name:ASRA R JAVEED DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:ASRA
Authorized Official - Middle Name:R
Authorized Official - Last Name:JAVEED
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:757-498-6420
Mailing Address - Street 1:4312 HOLLAND RD STE 108
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-1196
Mailing Address - Country:US
Mailing Address - Phone:757-498-6420
Mailing Address - Fax:
Practice Address - Street 1:4312 HOLLAND RD STE 108
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452
Practice Address - Country:US
Practice Address - Phone:757-498-6420
Practice Address - Fax:757-498-0982
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ATLANTIC DENTAL CARE, PLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-11-01
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty