Provider Demographics
NPI:1477745776
Name:JAYME TOMCHIK, D.M.D., P.C.
Entity Type:Organization
Organization Name:JAYME TOMCHIK, D.M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAYME
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:TOMCHIK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:757-460-2250
Mailing Address - Street 1:4624 PEMBROKE BLVD
Mailing Address - Street 2:SUITE #103
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-6450
Mailing Address - Country:US
Mailing Address - Phone:757-460-2250
Mailing Address - Fax:757-460-1865
Practice Address - Street 1:4624 PEMBROKE BLVD
Practice Address - Street 2:SUITE #103
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-6450
Practice Address - Country:US
Practice Address - Phone:757-460-2250
Practice Address - Fax:757-460-1865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-10
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010079351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty