Provider Demographics
NPI:1508605205
Name:DYKE, JARED (DMD)
Entity type:Individual
Prefix:DR
First Name:JARED
Middle Name:
Last Name:DYKE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1807 LIBBIE AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-1837
Mailing Address - Country:US
Mailing Address - Phone:804-288-9111
Mailing Address - Fax:
Practice Address - Street 1:1807 LIBBIE AVE STE 100
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-1837
Practice Address - Country:US
Practice Address - Phone:804-288-9111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-22
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014188841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice