Provider Demographics
NPI:1881790897
Name:COVEY, ROBERT DRAKE (DDS)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:DRAKE
Last Name:COVEY
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 1:7802 TIMBERLAKE ROAD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502
Mailing Address - Country:US
Mailing Address - Phone:434-239-6948
Mailing Address - Fax:434-239-9158
Practice Address - Street 1:7802 TIMBERLAKE ROAD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502
Practice Address - Country:US
Practice Address - Phone:434-239-6948
Practice Address - Fax:434-239-9158
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010054171223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA008214166Medicaid
VA15487OtherDORAL