Provider Demographics
NPI:1891178299
Name:AMELOTTI, DANTE LUIS (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:DANTE
Middle Name:LUIS
Last Name:AMELOTTI
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12528 WARWICK BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-2958
Mailing Address - Country:US
Mailing Address - Phone:757-599-8393
Mailing Address - Fax:
Practice Address - Street 1:12528 WARWICK BLVD STE D
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-2958
Practice Address - Country:US
Practice Address - Phone:757-599-8393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-02
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401414902122300000X, 1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No122300000XDental ProvidersDentist