Provider Demographics
NPI:1922033380
Name:SCHRUMPF, GREGORY ALLEN (DDS,FAGD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:ALLEN
Last Name:SCHRUMPF
Suffix:
Gender:M
Credentials:DDS,FAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1313 LINKS CT
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-9450
Mailing Address - Country:US
Mailing Address - Phone:757-436-2641
Mailing Address - Fax:
Practice Address - Street 1:1300 KEMPSVILLE RD STE 1
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-6199
Practice Address - Country:US
Practice Address - Phone:757-467-8181
Practice Address - Fax:757-467-1330
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA54-16678641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA817475OtherUNITED CONCORDIA COMPANIE
VA020196OtherUNITED CONCORDIA COMPANIE
VA088615OtherBLUE CROSS/BLUE SHIELD