| Derrick M. Broadaway, D.d.s., Pc | |
|
3809 Princess Anne Rd Suite 111 Virginia Beach VA 23456-1900 | |
| (757) 471-6672 | |
| Not Available |
| Full Name | Derrick M. Broadaway, D.d.s., Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3809 Princess Anne Rd, Virginia Beach, Virginia |
| Authorized Official Name and Position | Joyce S Davis (OFFICE MANAGER) |
| Authorized Official Contact | 7574716672 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Derrick M. Broadaway, D.d.s., Pc 3809 Princess Anne Rd Suite 111 Virginia Beach VA 23456-1900 Ph: (757) 471-6672 | Derrick M. Broadaway, D.d.s., Pc 3809 Princess Anne Rd Suite 111 Virginia Beach VA 23456-1900 Ph: (757) 471-6672 |
| NPI Number | 1316156102 |
|---|---|
| Provider Enumeration Date | 05/21/2007 |
| Last Update Date | 04/07/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316156102 | NPI | - | NPPES |
| 000000005259 | Other | VA | UNITED HEALTHCARE PROVIDE |
| 619881 | Other | VA | UNITED CONCORDIA PROVIDER |
| 219275 | Other | VA | BLUE CROSS PROVIDER # |
| 000000005259 | Other | VA | DENTAL BENEFITS PROVIDER# |
| 106546 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (Virginia) | Primary |
Dentistry First, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 5564 Indian River Rd, Virginia Beach, VA 23464 Phone: 757-366-5084 Fax: 757-366-5095 | |
Comfort Care Dental Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1385 Fordham Dr Ste 106, Virginia Beach, VA 23464 Phone: 757-451-7003 Fax: 757-420-2177 | |
Red Mill Pediatric Dentistry, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2336 Elson Green Ave Ste 101, Virginia Beach, VA 23456 Phone: 757-301-2064 | |
Pediatric Dental Care Of Tidewater Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2029 Lynnhaven Pkwy, Virginia Beach, VA 23456 Phone: 757-703-1923 | |
Bonney Road Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3933 Bonney Rd, Virginia Beach, VA 23452 Phone: 757-339-2154 | |