LEISURE DENTAL (NPI# 1366909046) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366909046 |
| Entity Type | Organization |
| Organization Name | LEISURE DENTAL |
| Practice Address |
7870 Tidewater Dr Unit 202-203 Norfolk VA 23505-3713 |
| Mailing Address |
4316 Hillingdon Bnd Apt 102 Chesapeake VA 23321-2458 |
| Practice Telephone | 7572223880 |
| Practice Fax Number | 7572225137 |
| Mailing Telephone | 2149915166 |
| Mailing Fax Number | 7572225137 |
| Enumeration Date | 2019-02-28 |
| Last Update Date | 2019-02-28 |
| Authorized Official Name | DR. BRUCE HAGGERTY JR. (OWNER/DENTIST) |
| Authorized Official Telephone | 2149915166 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | LEISURE DENTAL PLLC | 4316 Hillingdon Bend, Unit 102, Chesapeake, Virginia 23321 |
| Street Address |
7870 TIDEWATER DR UNIT 202-203 |
| City | NORFOLK |
| State | VA |
| Zip Code | 23505-3713 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154844256 | Cassandra Shelton | Specialist/Technologist, Other | 100 Kingsley Lane, Norfolk, VA 23505 | 2017-07-20 |
| 1063942852 | Gabriela Marie Santiago | Specialist/Technologist | 7600 Victory Dr, Apt 3, Norfolk, VA 23505 | 2017-06-14 |
| 1144776725 | Amr Hassan | Pharmacist | 1610 W Little Creek Rd, Apt 204, Norfolk, VA 23505 | 2016-09-01 |
| 1992175095 | Heather Mitchell | Nurse Practitioner | 110 Kingsley Ln Ste 309, Norfolk, VA 23505 | 2015-10-01 |
| 1255710620 | Jessica Ann Kestranek | Dentist | 7400 Granby St Ste D, Norfolk, VA 23505 | 2015-05-19 |
| 1710375274 | Carla Toledo | Nurse Practitioner | 155 Kingsley Lane, Suite 400, Norfolk, VA 23505 | 2015-01-06 |
| 1417359746 | James Austin Valone Jr. | Ophthalmology | 1423 Runymede Rd, Norfolk, VA 23505 | 2014-09-18 |
| 1861813370 | Harris Teeter, LLC | Pharmacy | 7550 Granby Street, Norfolk, VA 23505 | 2013-12-31 |
| 1649549361 | Linda Horsey | Social Worker | 7510 Granby Street, Suite 6, Norfolk, VA 23505 | 2011-12-27 |
| 1679705164 | Carolyn Lee Kee | Nurse's Aide | 7403 Hampton Blvd, Norfolk, VA 23505 | 2009-08-17 |
| Find all providers in zip 23505 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275903890 | Xi Sun Dmd LLC | Clinic/Center | 158 Main St, Norfolk, MA 02056-1301 | 2015-09-25 |
| 1396179743 | Ghent Family Dentistry, LLC | Clinic/Center | 2200 Colonial Ave, Suite 12, Norfolk, VA 23517-1915 | 2013-08-21 |
| 1285987735 | Ponca Tribe of Nebraska | Clinic/Center | 1800 Syracuse Ave, Norfolk, NE 68701-2458 | 2012-10-22 |
| 1669666913 | Mitchell Pasenkoff, Dmd | Clinic/Center | 146 Main St, Suite 2a, Norfolk, MA 02056-1322 | 2007-08-30 |
| 1235251109 | Carmen A. Cote, Dds, PC | Clinic/Center | 7913 Azalea Garden Rd, Suite A, Norfolk, VA 23518 | 2007-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780284679 | Dr Gina Askander PC | Clinic/Center | 4660 Kenmore Ave Ste 318, Alexandria, VA 22304-1306 | 2020-10-29 |
| 1992303242 | Anderson Dental Associates IIi, Pllc | Clinic/Center | 15609 Wingspan Ct, Woodbridge, VA 22193-1103 | 2020-10-09 |
| 1952914970 | Azul Family Dentistry LLC | Clinic/Center | 9605 Critzers Shop Rd, Afton, VA 22920-2416 | 2020-08-28 |
| 1083225429 | Long Ridge Dentistry, PC | Clinic/Center | 2780 Stuarts Draft Hwy Ste 102, Stuarts Draft, VA 24477-2779 | 2020-08-10 |
| 1942810882 | Lexington Smiles, Pllc | Clinic/Center | 123 S Randolph St, Lexington, VA 24450-2065 | 2020-08-05 |
| 1437767670 | Brad Spano Dds, P.C. | Clinic/Center | 1200 Five Springs Rd Ste 101, Charlottesville, VA 22902-8756 | 2020-07-14 |
| 1912525908 | Carabella Dental | Clinic/Center | 420 South Pickett Street, Alexandria, VA 22304-2230 | 2020-07-07 |
| 1669097044 | Lortontown Dental | Clinic/Center | 9010 Lorton Station Blvd Ste 135, Lorton, VA 22079-4794 | 2020-06-11 |
| 1578187035 | Karande Dental Care | Clinic/Center | 2063 Jefferson Davis Hwy Ste 1, Stafford, VA 22554-7291 | 2020-06-01 |
| 1326662917 | Hideki Seto, Dds Pllc | Clinic/Center | 8551 Rixlew Ln Ste 130, Manassas, VA 20109-4277 | 2020-05-30 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.