Active NPI
Emily M Dimitroff, DDS
- Dentist
- Virginia Beach, VA
National Provider Identifier
1366704397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 0401413616
- Practice address
- 1767 Princess Anne Rd
Virginia Beach, VA 23456-3835 - Phone
- (757) 426-6151
- NPI assigned
- Jun 14, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 0401413616 | VA | |
| Public Health Dentistry | 1223D0001X | 0401413116 | VA | |
| Dentist | 122300000X | 0401413616 | VA | Primary |
Addresses
Primary practice location
1767 Princess Anne Rd
Virginia Beach, VA 23456-3835
Mailing address
1767 Princess Anne Rd
Virginia Beach, VA 23456-3835
Phone (757) 426-6151
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401413616 | VA | MD | Dentist |
| 0401413116 | VA | MD | Public Health Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blue Heron Dental, PLLC | General Practice | Current | Accepting new patients |
| Konikoff Dental Associates, Inc. | General Practice | Past | Accepting new patients |
Locations
1767 Princess Anne Rd
Virginia Beach, VA 23456
Phone (757) 426-6151
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Virginia Beach, VA
- NPI 1235095191
-
- General Practice Dentistry
- Virginia Beach, VA
- NPI 1063570968
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1767139200000",
"number": "1366704397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1767 PRINCESS ANNE RD",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234563835",
"telephone_number": "757-426-6151"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1767 PRINCESS ANNE RD",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234563835",
"telephone_number": "757-426-6151"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIMITROFF",
"first_name": "EMILY",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-14",
"last_updated": "2025-12-31",
"certification_date": "2025-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "VA",
"license": "0401413616",
"primary": false
},
{
"code": "1223D0001X",
"taxonomy_group": "",
"desc": "Dentist, Dental Public Health",
"state": "VA",
"license": "0401413116",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VA",
"license": "0401413616",
"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 Dec 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.