Provider Demographics
NPI:1972573558
Name:BREININGER, BYRON DAVID (DDS)
Entity type:Individual
Prefix:DR
First Name:BYRON
Middle Name:DAVID
Last Name:BREININGER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:B
Other - Middle Name:DAVID
Other - Last Name:BREININGER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:1453 KEMPSVILLE RD
Mailing Address - Street 2:SUITE #104
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-7319
Mailing Address - Country:US
Mailing Address - Phone:757-467-9622
Mailing Address - Fax:757-467-6920
Practice Address - Street 1:1453 KEMPSVILLE RD
Practice Address - Street 2:SUITE #104
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-7319
Practice Address - Country:US
Practice Address - Phone:757-467-9622
Practice Address - Fax:757-467-6920
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-25
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401008404122300000X
IN12008678A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist