| Konikoff Family Dentistry | |
|
7400 Granby St Ste D Norfolk VA 23505-3436 | |
| (757) 583-1535 | |
| Not Available |
| Full Name | Konikoff Family Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 7400 Granby St Ste D, Norfolk, Virginia |
| Authorized Official Name and Position | Ty Justice (DIRECTOR, PAYER RELATIONS) |
| Authorized Official Contact | 7578084984 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Konikoff Family Dentistry 9825 Kenwood Rd Ste 200 Blue Ash OH 45242-6252 Ph: (513) 808-4984 | Konikoff Family Dentistry 7400 Granby St Ste D Norfolk VA 23505-3436 Ph: (757) 583-1535 |
| NPI Number | 1548789969 |
|---|---|
| Provider Enumeration Date | 09/18/2017 |
| Last Update Date | 11/28/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548789969 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Secondary |
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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