Provider Demographics
NPI:1639338510
Name:CAPPS, ERIC R (DDS)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:R
Last Name:CAPPS
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 1:836 FIRST COLONIAL RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-6126
Mailing Address - Country:US
Mailing Address - Phone:757-428-8747
Mailing Address - Fax:757-422-8165
Practice Address - Street 1:836 FIRST COLONIAL RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-6126
Practice Address - Country:US
Practice Address - Phone:757-428-8747
Practice Address - Fax:757-422-8165
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-05
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401006771122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No122300000XDental ProvidersDentist