Provider Demographics
NPI:1649255522
Name:MEARES, WILLIAM ANTHONY II (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ANTHONY
Last Name:MEARES
Suffix:II
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 LYNNHAVEN PKWY
Mailing Address - Street 2:SUITE 170
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-7300
Mailing Address - Country:US
Mailing Address - Phone:757-200-6222
Mailing Address - Fax:757-200-6224
Practice Address - Street 1:621 LYNNHAVEN PKWY
Practice Address - Street 2:SUITE 170
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-7300
Practice Address - Country:US
Practice Address - Phone:757-200-6222
Practice Address - Fax:757-200-6224
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010088531223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics