| Dr Nicole Marie Reddout, DMD | |
|
1647 Admiral Taussig Blvd, Norfolk, VA 23511-2803 | |
| (757) 953-8605 | |
| Not Available |
| Full Name | Dr Nicole Marie Reddout |
|---|---|
| Gender | Female |
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 1647 Admiral Taussig Blvd, Norfolk, Virginia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790001436 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 0438000368 (Virginia) | Primary |
| 122300000X | Dentist | 0401415421 (Virginia) | Secondary |
| Entity Name | Roanoke Oral Surgery Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1104007384 PECOS PAC ID: 1456314681 Enrollment ID: O20041109000755 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Nicole Marie Reddout, DMD 112 Meridian Pl, Suffolk, VA 23435-3787 Ph: (702) 374-8217 | Dr Nicole Marie Reddout, DMD 1647 Admiral Taussig Blvd, Norfolk, VA 23511-2803 Ph: (757) 953-8605 |
Dr. Sojeong Kim, DDS Dentist Medicare: Medicare Enrolled Practice Location: 1647 Admiral Taussig Blvd, Norfolk, VA 23511 Phone: 757-953-8575 | |
Jasmine Schneider, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 7923 Halprin Dr, Norfolk, VA 23518 Phone: 757-587-0874 | |
Joseph Scott Anderson, DDS Dentist Medicare: Medicare Enrolled Practice Location: 1647 Admiral Taussig Blvd, Norfolk, VA 23511 Phone: 757-953-8592 | |
Thomas N Hawkins Jr., DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 1647 Admiral Taussig Blvd, Norfolk, VA 23511 Phone: 757-314-6609 | |
Dr. Samuel Heriges Chambers, D.M.D. Dentist Medicare: Medicare Enrolled Practice Location: Uss Trenton, Fpo/ae 09588-1719, Norfolk, VA 23707 Phone: 757-444-1450 | |
David Adam Myers, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 1647 Admiral Taussig Blvd, Norfolk, VA 23511 Phone: 757-953-8547 | |
Dr. Eric Scott Samuels, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 1647 Admiral Taussig Blvd, Norfolk, VA 23511 Phone: 757-843-9581 |