Douglas R Overstreet Jr., DDS
Individual provider Active NPI Dentist · Glenn Allen, VA
NPI 1851465637 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1851465637
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- VA07681 (VA)
- Practice address
- 11551 Nuckois Rd
Ste B
Glenn Allen, VA 23059 - Phone
- (804) 270-7737
- Fax
- (804) 270-7475
- NPI assigned
- Nov 20, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| VA07681 | VA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| River City Dentistry | Past | Accepting new patients | |
| Cooke Richardson & Overstreet DDS PC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | VA07681 | VA | Yes |
Addresses
Primary practice location
11551 Nuckois Rd
Ste B
Glenn Allen, VA 23059
Mailing address
11551 Nuckois Rd
Ste B
Glenn Allen, VA 23059
Phone (804) 270-7737
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 723292 | Other | VA | UNITED CONCORDIA |
| 111846 | Other | VA | ANTHEM |
Other providers in Glenn Allen, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.