Provider Demographics
NPI:1619260312
Name:BECKER, ADAM (DDS)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:BECKER
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 1:621 LYNNHAVEN PKWY STE 170
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-7339
Mailing Address - Country:US
Mailing Address - Phone:757-200-6222
Mailing Address - Fax:757-200-6224
Practice Address - Street 1:621 LYNNHAVEN PKWY STE 170
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-7339
Practice Address - Country:US
Practice Address - Phone:757-200-6222
Practice Address - Fax:757-200-6224
Is Sole Proprietor?:No
Enumeration Date:2011-05-27
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014137141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice