Provider Demographics
NPI:1770214280
Name:IRBY, JOSHUA (DDS)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:IRBY
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 1:405 CEDAR RIDGE TER
Mailing Address - Street 2:
Mailing Address - City:SOUTH BOSTON
Mailing Address - State:VA
Mailing Address - Zip Code:24592-2936
Mailing Address - Country:US
Mailing Address - Phone:434-470-2478
Mailing Address - Fax:
Practice Address - Street 1:410 MINERAL ST
Practice Address - Street 2:
Practice Address - City:SOUTH BOSTON
Practice Address - State:VA
Practice Address - Zip Code:24592-3716
Practice Address - Country:US
Practice Address - Phone:434-572-4928
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-23
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401417931122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice