Provider Demographics
NPI:1023109279
Name:DENISON, JOHN JEFFERY (DDS)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:JEFFERY
Last Name:DENISON
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 1:50 DILLWYN DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23602-7372
Mailing Address - Country:US
Mailing Address - Phone:757-877-6533
Mailing Address - Fax:
Practice Address - Street 1:895 MIDDLE GROUND BLVD
Practice Address - Street 2:SUITE 106
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4250
Practice Address - Country:US
Practice Address - Phone:757-873-9000
Practice Address - Fax:757-257-3997
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA8258122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist