Provider Demographics
NPI:1265563613
Name:CAMPBELL, MASON-LEIGH MORRIS (DDS)
Entity type:Individual
Prefix:DR
First Name:MASON-LEIGH
Middle Name:MORRIS
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:MASON
Other - Middle Name:MORRIS
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:2248 RUSSET LEAF LN
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456
Mailing Address - Country:US
Mailing Address - Phone:804-543-1931
Mailing Address - Fax:
Practice Address - Street 1:2100 LYNNHAVEN PKWY STE 100
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-1492
Practice Address - Country:US
Practice Address - Phone:757-416-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014115291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice