Provider Demographics
NPI:1386824449
Name:KAPLAN, MARVIN I (DDS)
Entity Type:Individual
Prefix:
First Name:MARVIN
Middle Name:I
Last Name:KAPLAN
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 1:113 BYRON ST
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-5160
Mailing Address - Country:US
Mailing Address - Phone:757-436-4302
Mailing Address - Fax:757-436-0185
Practice Address - Street 1:113 BYRON ST
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-5160
Practice Address - Country:US
Practice Address - Phone:757-436-4302
Practice Address - Fax:757-436-0185
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-06
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA30051223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005147Medicaid