Individual
STEVEN A. CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3410 COUNTY ST, PORTSMOUTH, VA 23707-3205
(757) 393-2568
(757) 399-5069
Mailing address
3410 COUNTY ST, PORTSMOUTH, VA 23707-3205
(757) 393-2568
(757) 399-5069
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401007119
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050060
ANTHEM PROVIDER ID
VA
01
—
062287
UNITED CONCORDIA PROVIDER
VA
01
—
2726
DOMINION DENTAL PROVIDER
VA
Enumeration date
09/17/2006
Last updated
07/08/2007
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