Provider Demographics
NPI:1437827433
Name:HAMZEY, RENA JUSTINE (DMD)
Entity type:Individual
Prefix:DR
First Name:RENA
Middle Name:JUSTINE
Last Name:HAMZEY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3189 RIVER RD W
Mailing Address - Street 2:
Mailing Address - City:GOOCHLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23063-3208
Mailing Address - Country:US
Mailing Address - Phone:804-678-8267
Mailing Address - Fax:
Practice Address - Street 1:4501 S LABURNUM AVE STE 540
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23231-2494
Practice Address - Country:US
Practice Address - Phone:804-737-2403
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-03
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401417672122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist