Provider Demographics
NPI:1437216959
Name:GAIL V. PLAUKA, D.M.D., P.C.
Entity Type:Organization
Organization Name:GAIL V. PLAUKA, D.M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JORDANA
Authorized Official - Middle Name:
Authorized Official - Last Name:EFLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-482-4777
Mailing Address - Street 1:350 JOHNSTOWN RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-5365
Mailing Address - Country:US
Mailing Address - Phone:757-482-4777
Mailing Address - Fax:
Practice Address - Street 1:350 JOHNSTOWN RD
Practice Address - Street 2:SUITE C
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-5365
Practice Address - Country:US
Practice Address - Phone:757-482-4777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010062181223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA8221979Medicaid
VAU41185Medicare UPIN