Individual provider Active NPI

Elmer Leonard Reaves Jr., D.D.S.

  • Public Health Dentistry
  • Hampton, VA
National Provider Identifier
1780674879
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health DentistryTaxonomy code 1223D0001X
License
0401005262 Issued in VA
Practice address
1320 Lasalle Ave
Hampton, VA 23669-3801
Phone
(757) 727-2585
Fax
(757) 727-4881
NPI assigned
Oct 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health Dentistry 1223D0001X 0401005262 VA Primary

Addresses

Primary practice location

1320 Lasalle Ave
Hampton, VA 23669-3801

Mailing address

1304 Braddock Ave
Virginia Beach, VA 23455-4102
Phone (757) 363-9568

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
0401005262VAMDPublic Health Dentist

NPI Registry JSON

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1780674879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 BRADDOCK AVE",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234554102",
            "telephone_number": "757-363-9568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 LASALLE AVE",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236693801",
            "telephone_number": "757-727-2585",
            "fax_number": "757-727-4881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REAVES",
        "first_name": "ELMER",
        "middle_name": "LEONARD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-28",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "VA",
            "license": "0401005262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.