Organization Active NPI

Miguel Fernandez DDS, LTD

  • General Practice Dentistry
  • Virginia Beach, VA
National Provider Identifier
1730390998
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MIGUEL FERNANDEZ DDS, LTD
Practice address
520 S Independence Blvd Ste 102
Virginia Beach, VA 23452-1152
Phone
(757) 497-4825
Fax
(757) 497-1206
NPI assigned
May 26, 2007
Last updated
Mar 14, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Authorized official

Name
Dr. Miguel Eduardo Fernandez, DDSNPI 1184646390
Title
President
Phone
(747) 497-4825

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary
Customized Equipment (DME) 332BC3200X

Addresses

Primary practice location

520 S Independence Blvd Ste 102
Virginia Beach, VA 23452-1152

Mailing address

520 S Independence Blvd Ste 102
Virginia Beach, VA 23452-1152
Phone (757) 497-4825

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250520003896 VA DME Supplier - Oral Surgery - Dentist 1254859457 Practice locations: Virginia Beach, VA

National Provider Directory

National Provider Directory
Tax ID family
Atlantic Dental Care PLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5121 Greenwich Rd
Ste 102
Virginia Beach, VA 23462

520 S Independence Blvd
Ste 102
Virginia Beach, VA 23452
Phone (757) 497-4825

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1180137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741910400000",
    "number": "1730390998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 S INDEPENDENCE BLVD STE 102",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234521152",
            "telephone_number": "757-497-4825",
            "fax_number": "757-497-1206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S INDEPENDENCE BLVD STE 102",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234521152",
            "telephone_number": "757-497-4825",
            "fax_number": "757-497-1206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIGUEL FERNANDEZ DDS, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-26",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-13",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "MIGUEL",
        "authorized_official_middle_name": "EDUARDO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "747-497-4825",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Mar 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.