Provider Demographics
NPI:1821010166
Name:NEAL, JEFFREY ANDERSON (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:ANDERSON
Last Name:NEAL
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 1:2215 PUMP RD
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23233-3507
Mailing Address - Country:US
Mailing Address - Phone:804-447-1435
Mailing Address - Fax:804-447-3932
Practice Address - Street 1:2215 PUMP RD
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23233-3507
Practice Address - Country:US
Practice Address - Phone:804-447-1435
Practice Address - Fax:804-447-3932
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401008775122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist