Organization
KONIKOFF DENTAL ASSOCIATES, INC.
Active
Other names
Dental Care Alliance
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE COLE (VP INSURANCE PLAN MANAGEMENT)
(727) 424-2990
Entity
Organization
Contact information
Practice address
2100 LYNNHAVEN PKWY, SUITE 100, VIRGINIA BEACH, VA 23456-1492
(757) 416-1800
(757) 416-9276
Mailing address
2100 LYNNHAVEN PKWY, SUITE 100, VIRGINIA BEACH, VA 23456-1492
(757) 416-1800
(757) 416-9276
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019711
ANTHEM
VA
01
—
816276
UNITED CONCORDIA
—
Enumeration date
12/04/2006
Last updated
07/21/2022
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