Provider Demographics
NPI:1013916360
Name:PAYNE, ALBERT LLOYD (DDS)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:LLOYD
Last Name:PAYNE
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 1:1921 STONY MILL RD
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-8204
Mailing Address - Country:US
Mailing Address - Phone:434-685-4305
Mailing Address - Fax:
Practice Address - Street 1:770 PINEY FOREST RD
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-2859
Practice Address - Country:US
Practice Address - Phone:434-799-8825
Practice Address - Fax:434-799-9458
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401005019122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA463688OtherBCBS
VA923 83924PAYOtherOTHER
VA014297OtherDORAL