# MICHAEL EDENFIELD, DDS PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194013474
- **Authorized official:** MRS. NICOLA J PISMENY (PRACTICE ADMINISTRATOR)
- **Authorized official phone:** (757) 488-1285

## Contact information

- **Practice address:** 6263 PORTSMOUTH BLVD, PORTSMOUTH, VA 23701-1344
- **Practice address phone:** (757) 488-1285
- **Practice address fax:** (757) 465-9132
- **Mailing address:** 6263 PORTSMOUTH BLVD, PORTSMOUTH, VA 23701-1344
- **Mailing address phone:** (757) 488-1285
- **Mailing address fax:** (757) 465-9132

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 0401008978 | VA | Yes |

## Other

- **Enumeration date:** 07/20/2011
- **Last updated:** 07/20/2011