Organization
COASTAL PEDIATRIC DENTAL & ANESTHESIA, PLLC
Active
Other names
Jillian Reynolds, DDS & Jonathan L Wong, DMD , PLLC, Coastal Pediatric Dental & Anesthesia
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN L WONG DMD (OWNER)
(757) 963-0001
Entity
Organization
Contact information
Practice address
6161 KEMPSVILLE CIR, SUITE 345, NORFOLK, VA 23502-3932
(602) 799-1748
Mailing address
303 55TH ST UNIT A, VIRGINIA BEACH, VA 23451-2213
(602) 799-1748
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
0401414467
VA
1223D0004X
Dental Anesthesiology
Primary
0447000045
VA
1223P0221X
Pediatric Dentistry
0401413751
VA
Other
Enumeration date
03/23/2017
Last updated
03/24/2026
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