Provider Demographics
NPI:1568636587
Name:DR A SOLOMON DDS & ASS FAMILY DENTISTRY PC
Entity type:Organization
Organization Name:DR A SOLOMON DDS & ASS FAMILY DENTISTRY PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:NIKKI
Authorized Official - Middle Name:
Authorized Official - Last Name:BYNUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-547-2171
Mailing Address - Street 1:805 N BATTLEFIELD BLVD
Mailing Address - Street 2:STE 125
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320
Mailing Address - Country:US
Mailing Address - Phone:757-547-2171
Mailing Address - Fax:757-547-9644
Practice Address - Street 1:805 N BATTLEFIELD BLVD
Practice Address - Street 2:STE 125
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320
Practice Address - Country:US
Practice Address - Phone:757-547-2171
Practice Address - Fax:757-547-9644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-22
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA4303VA1223G0001X
1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1174513568OtherINDIVIDUAL NPI
VA1043200447OtherINDIVIDUAL NPI