# MIGUEL FERNANDEZ DDS, LTD

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

## Provider details

- **NPI number:** 1730390998
- **Authorized official:** DR. MIGUEL EDUARDO FERNANDEZ DDS (PRESIDENT)
- **Authorized official phone:** (747) 497-4825

## Contact information

- **Practice address:** 520 S INDEPENDENCE BLVD STE 102, VIRGINIA BEACH, VA 23452-1152
- **Practice address phone:** (757) 497-4825
- **Practice address fax:** (757) 497-1206
- **Mailing address:** 520 S INDEPENDENCE BLVD STE 102, VIRGINIA BEACH, VA 23452-1152
- **Mailing address phone:** (757) 497-4825
- **Mailing address fax:** (757) 497-1206

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |
| 332BC3200X | Customized Equipment (DME) | — | NULL | — |

## Other

- **Enumeration date:** 05/26/2007
- **Last updated:** 03/14/2025