Provider Demographics
NPI:1639575525
Name:JOHN J DENISON, DDS PC
Entity Type:Organization
Organization Name:JOHN J DENISON, DDS PC
Other - Org Name:A DIVISION OF ATLANTIC DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:DENISON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:757-873-9000
Mailing Address - Street 1:895 CITY CENTER BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-3080
Mailing Address - Country:US
Mailing Address - Phone:757-873-9000
Mailing Address - Fax:757-257-3997
Practice Address - Street 1:895 CITY CENTER BLVD STE 106
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-3080
Practice Address - Country:US
Practice Address - Phone:757-873-9000
Practice Address - Fax:757-257-3997
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ATLANTIC DENTAL CARE, PLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-11-05
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401008258122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty