Estrada & Estrada, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

07715 Issued in VA

Legal business name

ESTRADA & ESTRADA, PC

Practice address

1354 Kempsville Rd
Suite 101
Chesapeake, VA 23320-1416

Phone

(757) 548-1611

Fax

(757) 548-1051

NPI assigned

Oct 19, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Craig W.T. Estrada, DDS

Title

President

Phone

(757) 548-1611

Specialties & licenses 3

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1192752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192752000000",
    "number": "1417146044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1354 KEMPSVILLE RD",
            "address_2": "SUITE 101",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233201416",
            "telephone_number": "757-548-1611",
            "fax_number": "757-548-1051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1354 KEMPSVILLE RD",
            "address_2": "SUITE 101",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233201416",
            "telephone_number": "757-548-1611",
            "fax_number": "757-548-1051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESTRADA & ESTRADA, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-19",
        "last_updated": "2007-10-19",
        "status": "A",
        "authorized_official_last_name": "ESTRADA",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "W.T.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "757-548-1611",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "06969",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "07715",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "10774",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL",
            "identifier": "1275686511",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL",
            "identifier": "1194705111",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL",
            "identifier": "1497808737",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Estrada & Estrada, PC
• Charito Mangaya Estrada, DDS
• Craig Wayne Tamondong Estrada, D.D.S.
• Melissa Tan Estrada, APRN
• Daniel M Etheridge, DDS
• Anne Kristine Moore Etherton, RD

• General Practice Dentistry in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2007; 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.