Provider Demographics
NPI:1255772497
Name:WINTER, PAMELA ANNETTE (DDS)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:ANNETTE
Last Name:WINTER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 JOHNSTOWN RD STE C
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-5365
Mailing Address - Country:US
Mailing Address - Phone:757-482-4777
Mailing Address - Fax:
Practice Address - Street 1:350 JOHNSTOWN RD STE C
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-5365
Practice Address - Country:US
Practice Address - Phone:757-482-4777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-16
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCDGD.8264GD122300000X
VA0401414768122300000X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist