Provider Demographics
NPI:1932218799
Name:STARNS, DOUGLAS LEE (DDS)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:LEE
Last Name:STARNS
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 1:240 HYDRAULIC RIDGE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901
Mailing Address - Country:US
Mailing Address - Phone:434-973-1392
Mailing Address - Fax:434-973-1313
Practice Address - Street 1:240 HYDRAULIC RIDGE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901
Practice Address - Country:US
Practice Address - Phone:434-973-1392
Practice Address - Fax:434-973-1313
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010057871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2751836OtherVA EMPLOYMENT COMMISSION