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JILLIAN REYNOLDS DDS & JONATHAN L WONG DMD PLLC NPI 1184155962


NPI Information

NPI: 1184155962
Provider Name: JILLIAN REYNOLDS, DDS & JONATHAN L WONG, DMD , PLLC

Doing Business As: COASTAL PEDIATRIC DENTAL & ANESTHESIA

Classification: Dentist - 1223D0004X
Entity Type: Organization

Specialization: Dentist Anesthesiologist

Address:
6161 KEMPSVILLE CIR
SUITE 345
NORFOLK, VA
ZIP 23502
Phone: (602) 799-1748
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JILLIAN REYNOLDS, DDS & JONATHAN L WONG, DMD , PLLC is a dentist anesthesiologist dentist in Norfolk, VA. The provider is a dentist who has successfully completed an accredited postdoctoral anesthesiology residency training program for dentists of two or more years duration, in accord with Commission on Dental Accreditation's Standards for Dental Anesthesiology Residency Programs, and/or meets the eligibility requirements for examination by the American Dental Board of Anesthesiology. JILLIAN REYNOLDS, DDS & JONATHAN L WONG, DMD , PLLC NPI is 1184155962. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Coastal Pediatric Dental & Anesthesia.

The provider's business location address is:

6161 KEMPSVILLE CIR
SUITE 345
NORFOLK, VA
ZIP 23502-932
Phone: (602) 799-1748

The provider's authorized official is Jonathan Lawrence Wong .
The authorized official title is Dentist Anesthesiologist, Owner and has the following contact phone number (602) 799-1748.

The enumeration date for this NPI number is 3/23/2017 and was last updated on 2/17/2024.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1122300000XDentist0401414467VIRGINIANo
21223P0221XDentistPediatric Dentistry0401413751VIRGINIANo
31223D0004XDentistDentist Anesthesiologist0447000045VIRGINIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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