Provider Demographics
NPI:1710284088
Name:JOSEPH N TREGASKES DMD MS INC
Entity Type:Organization
Organization Name:JOSEPH N TREGASKES DMD MS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:N
Authorized Official - Last Name:TREGASKES
Authorized Official - Suffix:
Authorized Official - Credentials:DMD MS
Authorized Official - Phone:804-282-0510
Mailing Address - Street 1:2008 BREMO RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-2443
Mailing Address - Country:US
Mailing Address - Phone:804-282-0510
Mailing Address - Fax:804-282-1346
Practice Address - Street 1:2008 BREMO RD
Practice Address - Street 2:SUITE 104
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-2443
Practice Address - Country:US
Practice Address - Phone:804-282-0510
Practice Address - Fax:804-282-1346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-22
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010004312122300000X
VA0401004312332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6490460001Medicare NSC