Provider Demographics
NPI:1134224785
Name:SCHONBRUN, DAVID WILLIAM (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:WILLIAM
Last Name:SCHONBRUN
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 1:4529 E HONEYGROVE RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-6087
Mailing Address - Country:US
Mailing Address - Phone:757-460-1234
Mailing Address - Fax:757-464-2524
Practice Address - Street 1:4529 E HONEYGROVE RD
Practice Address - Street 2:SUITE 301
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-6087
Practice Address - Country:US
Practice Address - Phone:757-460-1234
Practice Address - Fax:757-464-2524
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010076111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0401007611OtherLISCENSE
VA017812OtherANTHEM