Provider Demographics
NPI:1194884866
Name:PERLMAN, STEVEN LAYNE (DDS)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:LAYNE
Last Name:PERLMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 W MERCURY BLVD
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-3700
Mailing Address - Country:US
Mailing Address - Phone:757-826-7372
Mailing Address - Fax:757-826-1739
Practice Address - Street 1:4000 W MERCURY BLVD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-3700
Practice Address - Country:US
Practice Address - Phone:757-826-7372
Practice Address - Fax:757-826-1739
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010065631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice