Provider Demographics
NPI:1710259429
Name:ERVIL, STEVIE (DDS)
Entity Type:Individual
Prefix:
First Name:STEVIE
Middle Name:
Last Name:ERVIL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9101 STONY POINT PKWY APT 1343
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23235-2063
Mailing Address - Country:US
Mailing Address - Phone:301-356-8375
Mailing Address - Fax:
Practice Address - Street 1:8579 IVOR ROAD
Practice Address - Street 2:
Practice Address - City:IVOR
Practice Address - State:VA
Practice Address - Zip Code:23866
Practice Address - Country:US
Practice Address - Phone:757-859-9070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-27
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY060205122300000X
VA0401417136122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist