Provider Demographics
NPI:1962893453
Name:R. SCOTT PARR, DDS PC
Entity type:Organization
Organization Name:R. SCOTT PARR, DDS PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:PARR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:757-473-8482
Mailing Address - Street 1:200 GRAYSON RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-3745
Mailing Address - Country:US
Mailing Address - Phone:757-473-8482
Mailing Address - Fax:757-473-8486
Practice Address - Street 1:200 GRAYSON RD
Practice Address - Street 2:SUITE 100
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-3745
Practice Address - Country:US
Practice Address - Phone:757-473-8482
Practice Address - Fax:757-473-8486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-05
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010070971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1497873459OtherNPI
VA1720168917OtherNPI
CA1679068696OtherNPI