Provider Demographics
NPI:1417067182
Name:MEEKS, DARRELL ALAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:DARRELL
Middle Name:ALAN
Last Name:MEEKS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:281 INDEPENDENCE BLVD
Mailing Address - Street 2:SUITE 225
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462
Mailing Address - Country:US
Mailing Address - Phone:757-499-5909
Mailing Address - Fax:757-499-7058
Practice Address - Street 1:711 GREENBRIER PARKWAY
Practice Address - Street 2:SUITE 103
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320
Practice Address - Country:US
Practice Address - Phone:757-548-1712
Practice Address - Fax:757-549-1484
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04380001491223G0001X, 1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1223G0001XDental ProvidersDentistGeneral Practice
Not Answered1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
T54095Medicare UPIN