Provider Demographics
NPI:1013097914
Name:KING, CHRISTOPHER LARMOR (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:LARMOR
Last Name:KING
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 1:1835 GRAVES MILL RD
Mailing Address - Street 2:
Mailing Address - City:FOREST
Mailing Address - State:VA
Mailing Address - Zip Code:24551-3967
Mailing Address - Country:US
Mailing Address - Phone:434-316-9220
Mailing Address - Fax:434-316-9220
Practice Address - Street 1:1835 GRAVES MILL RD
Practice Address - Street 2:
Practice Address - City:FOREST
Practice Address - State:VA
Practice Address - Zip Code:24551-3967
Practice Address - Country:US
Practice Address - Phone:434-316-9220
Practice Address - Fax:434-316-9220
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401008280122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
139161OtherANTHEM BCBS
VA9178739Medicaid