Provider Demographics
NPI:1851263008
Name:COLLEEN MORENO DDS PLLC
Entity type:Organization
Organization Name:COLLEEN MORENO DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MORENO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:571-276-4334
Mailing Address - Street 1:524 ALBEMARLE DR STE 9
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-5500
Mailing Address - Country:US
Mailing Address - Phone:757-547-7070
Mailing Address - Fax:757-842-6391
Practice Address - Street 1:524 ALBEMARLE DR
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-5500
Practice Address - Country:US
Practice Address - Phone:757-547-7070
Practice Address - Fax:757-842-6391
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ATLANTIC DENTAL CARE, PLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-09-18
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental