| Virginia Beach Dental Spa, Pllc | |
|
9305 Quioccasin Rd Ste A Richmond VA 23229-5429 | |
| (804) 251-1233 | |
| (804) 750-1880 |
| Full Name | Virginia Beach Dental Spa, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 9305 Quioccasin Rd Ste A, Richmond, Virginia |
| Authorized Official Name and Position | Firas Albadran (OWNER) |
| Authorized Official Contact | 6175057082 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Virginia Beach Dental Spa, Pllc 9305 Quioccasin Rd Ste A Richmond VA 23229-5429 Ph: (804) 251-1233 | Virginia Beach Dental Spa, Pllc 9305 Quioccasin Rd Ste A Richmond VA 23229-5429 Ph: (804) 251-1233 |
| NPI Number | 1386118990 |
|---|---|
| Provider Enumeration Date | 01/16/2019 |
| Last Update Date | 01/16/2019 |
| Medicare PECOS PAC ID | 7719309228 |
|---|---|
| Medicare Enrollment ID | O20200629002523 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386118990 | NPI | - | NPPES |
| 000012970362 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | Firas Albadran |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1740678341 PECOS PAC ID: 2163844671 Enrollment ID: I20200629002616 |
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