Provider Demographics
NPI:1508832445
Name:DUNHAM, THOMAS PATRICK (DDS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:PATRICK
Last Name:DUNHAM
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 1:2008 GENERAL BOOTH BLVD
Mailing Address - Street 2:STE A
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-5910
Mailing Address - Country:US
Mailing Address - Phone:757-427-7130
Mailing Address - Fax:757-427-7135
Practice Address - Street 1:2008 GENERAL BOOTH BLVD
Practice Address - Street 2:STE A
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-5910
Practice Address - Country:US
Practice Address - Phone:757-427-7130
Practice Address - Fax:757-427-7135
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA78981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
VABLUE CROSS BLUE SHIEOther141303
VAUNITED CONCORDIAOther808130
VADELTA DENTALOther043365