Provider Demographics
NPI:1134221740
Name:DENSON, JOHN BRINKLEY JR (DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:BRINKLEY
Last Name:DENSON
Suffix:JR
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 1:3522 BOULEVARD
Mailing Address - Street 2:STE E
Mailing Address - City:COLONIAL HEIGHTS
Mailing Address - State:VA
Mailing Address - Zip Code:23834-1304
Mailing Address - Country:US
Mailing Address - Phone:804-526-8638
Mailing Address - Fax:
Practice Address - Street 1:3522 BOULEVARD
Practice Address - Street 2:STE E
Practice Address - City:COLONIAL HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:23834-1304
Practice Address - Country:US
Practice Address - Phone:804-526-8638
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401005087122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist