Provider Demographics
NPI:1518049725
Name:LEMING, DEAN DEARCAS (DDS)
Entity Type:Individual
Prefix:
First Name:DEAN
Middle Name:DEARCAS
Last Name:LEMING
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:PO BOX 186
Mailing Address - Street 2:
Mailing Address - City:TAPPAHANNOCK
Mailing Address - State:VA
Mailing Address - Zip Code:22560-0186
Mailing Address - Country:US
Mailing Address - Phone:804-443-3820
Mailing Address - Fax:804-443-3855
Practice Address - Street 1:625 CHARLOTTE STREET
Practice Address - Street 2:
Practice Address - City:TAPPAHANNOCK
Practice Address - State:VA
Practice Address - Zip Code:22560
Practice Address - Country:US
Practice Address - Phone:804-443-3820
Practice Address - Fax:804-443-3855
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401412012122300000X
NC74541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89902KMMedicaid