Individual provider Active NPI

Martha Egeland-Lewis, DMD

  • Dentist
  • Chesapeake, VA
National Provider Identifier
1629034756
Registry record updated May 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401411399 Issued in VA
Practice address
825 Battlefield Blvd S
Chesapeake, VA 23322-6607
Phone
(757) 482-2876
Fax
(757) 546-0235
NPI assigned
Apr 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401411399 VA Primary

Addresses

Primary practice location

825 Battlefield Blvd S
Chesapeake, VA 23322-6607

Mailing address

825 Battlefield Blvd S
Chesapeake, VA 23322-6607
Phone (757) 482-2876

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

LicenseStateTypeSpecialty
0401411399VAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462924800000",
    "number": "1629034756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 BATTLEFIELD BLVD S",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233226607",
            "telephone_number": "757-482-2876",
            "fax_number": "757-546-0235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 BATTLEFIELD BLVD S",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233226607",
            "telephone_number": "757-482-2876",
            "fax_number": "757-546-0235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGELAND-LEWIS",
        "first_name": "MARTHA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-26",
        "last_updated": "2016-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401411399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2016; 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.