Provider Demographics
NPI:1568561900
Name:PARTNERS IN DENTAL HEALTH LLC
Entity Type:Organization
Organization Name:PARTNERS IN DENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:KENT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:757-499-2100
Mailing Address - Street 1:317 EDWIN DRIVE
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462
Mailing Address - Country:US
Mailing Address - Phone:757-499-2100
Mailing Address - Fax:757-499-2999
Practice Address - Street 1:317 EDWIN DRIVE
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462
Practice Address - Country:US
Practice Address - Phone:757-499-2100
Practice Address - Fax:757-499-2999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010054181223G0001X
VA04010064011223G0001X
VA04010087971223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Not Answered1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
179332OtherANTHEM DR LAURENCE
179333OtherANTHEM DR KENT
01398710OtherTRICARE DR DAVIS
179331OtherANTHEM DR DAVIS
794586OtherTRICARE DR LAURENCE
794586OtherTRICARE DR KENT