NPIMap

Organization Active NPI

Trent P Conelias DDS, PC

Doing business as Eastern Virginia Oral & Maxillofacial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Virginia Beach, VA
National Provider Identifier
1265929913
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
TRENT P CONELIAS DDS, PC
Doing business as
Eastern Virginia Oral & Maxillofacial Surgery
Practice address
6033 Providence Rd
Virginia Beach, VA 23464-3815
Phone
(757) 424-2672
NPI assigned
Apr 18, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Laura Shawver
Title
Practice Manager
Phone
(757) 424-2672

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X VA Primary

Addresses

Primary practice location

6033 Providence Rd
Virginia Beach, VA 23464-3815

Mailing address

6033 Providence Rd
Virginia Beach, VA 23464-3815
Phone (757) 424-2672

Other names 1

  • Eastern Virginia Oral & Maxillofacial Surgery Doing business as

National Provider Directory

National Provider Directory

Locations

6033 Providence Rd
Virginia Beach, VA 23464
Phone (757) 424-2672

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1524009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713830400000",
    "number": "1265929913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6033 PROVIDENCE RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234643815",
            "telephone_number": "757-424-2672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6033 PROVIDENCE RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234643815",
            "telephone_number": "757-424-2672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRENT P CONELIAS DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-18",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A",
        "authorized_official_last_name": "SHAWVER",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "757-424-2672",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eastern Virginia Oral & Maxillofacial Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.