Provider Demographics
NPI:1972656965
Name:STAGGS, LLOYD RUSSEL (DMD)
Entity Type:Individual
Prefix:DR
First Name:LLOYD
Middle Name:RUSSEL
Last Name:STAGGS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 COUNTRY CLUB BLVD
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-2137
Mailing Address - Country:US
Mailing Address - Phone:757-548-9976
Mailing Address - Fax:
Practice Address - Street 1:801 GREENBRIER PKWY
Practice Address - Street 2:SUITE A
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-3822
Practice Address - Country:US
Practice Address - Phone:757-547-3003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010070401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice