Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207YX0007X | Plastic Surgeon (Head & Neck) | 0101226095 | VA |
Y | 208200000X | Surgeon | 0101226095 | VA |
Y | 208600000X | Surgeon | 0101226095 | VA |
NPI | 1609843697 |
---|---|
Provider Name | Dr. Denton Dean Weiss |
First Address | Virginia Beach, VA 23452-1367 |
Second Address | Virginia Beach, VA 23452-1367 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2006 |
Last Update Date | 25/02/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10004168 | OPTIMA (01) | VA |
188308 | ANTHEM BC/BS VA (01) | VA |
41-2051174 | CIGNA (01) | VA |
7302834 | AETNA (01) | VA |
H34087 | (02) | VA |