NPIMap

Organization Active NPI

Virginia Enhanced Dental Services

  • Dentist
  • Virginia Beach, VA
National Provider Identifier
1316025349
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401006498 Issued in VA
Legal business name
VIRGINIA ENHANCED DENTAL SERVICES
Practice address
1301 First Colonial Road
Virginia Beach, VA 23454
Phone
(757) 463-1500
Fax
(757) 463-8727
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Jeffrey R Leidy, DMD
Title
President Owner
Phone
(757) 463-1500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 0401006498 VA Primary

Addresses

Primary practice location

1301 First Colonial Road
Virginia Beach, VA 23454

Mailing address

1301 First Colonial Road
Virginia Beach, VA 23454
Phone (757) 463-1500

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316025349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 FIRST COLONIAL ROAD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "23454",
            "telephone_number": "757-463-1500",
            "fax_number": "757-463-8727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 FIRST COLONIAL ROAD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "23454",
            "telephone_number": "757-463-1500",
            "fax_number": "757-463-8727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIRGINIA ENHANCED DENTAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEIDY",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "757-463-1500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401006498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 22, 2020; 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.