East Coast Centre for Cosmetic Dentistry and Facial Aesthetics

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401005366 Issued in VA

Legal business name

EAST COAST CENTRE FOR COSMETIC DENTISTRY AND FACIAL AESTHETICS

Practice address

3304 Arctic Ave
Virginia Beach, VA 23451-2913

Phone

(757) 481-3305

Fax

(757) 481-7157

NPI assigned

May 2, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Stanley Leroy Chickey, DDS

Title

President

Phone

(757) 481-3305

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1525219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1558850776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3304 ARCTIC AVE",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234512913",
            "telephone_number": "757-481-3305",
            "fax_number": "757-481-7157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3304 ARCTIC AVE",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234512913",
            "telephone_number": "757-481-3305",
            "fax_number": "757-481-7157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST COAST CENTRE FOR COSMETIC DENTISTRY AND FACIAL AESTHETICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-02",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "CHICKEY",
        "authorized_official_first_name": "STANLEY",
        "authorized_official_middle_name": "LEROY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "757-481-3305",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401005366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL NPI NUMBER",
            "identifier": "1770586216",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Virginia Beach, VA
• Providers in Virginia Beach, 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 Jun 16, 2018; 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.