Provider Demographics
NPI:1336274752
Name:TOMCHIK, JAYME DAVID (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAYME
Middle Name:DAVID
Last Name:TOMCHIK
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4624 PEMBROKE BLVD
Mailing Address - Street 2:SUITE #103
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-6450
Mailing Address - Country:US
Mailing Address - Phone:757-460-2250
Mailing Address - Fax:757-460-1865
Practice Address - Street 1:4624 PEMBROKE BLVD
Practice Address - Street 2:SUITE #103
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-6450
Practice Address - Country:US
Practice Address - Phone:757-460-2250
Practice Address - Fax:757-460-1865
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010079351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice