Provider Demographics
NPI:1861653974
Name:J A MERA DDSPC & ASSOCIATES
Entity Type:Organization
Organization Name:J A MERA DDSPC & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HOCKETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-379-9375
Mailing Address - Street 1:11507 ALLECINGIE PKWY
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23235-4301
Mailing Address - Country:US
Mailing Address - Phone:804-379-9375
Mailing Address - Fax:
Practice Address - Street 1:11507 ALLECINGIE PKWY
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-4301
Practice Address - Country:US
Practice Address - Phone:804-379-9375
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:J A MERA DDSPC & ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-20
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA4010069121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty