1619941747 NPI number — KENNETH FRANCIS MORE M.D.

Table of content: DR. LAI-FONG LEE DDS (NPI 1487716106)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619941747 NPI number — KENNETH FRANCIS MORE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MORE
Provider First Name:
KENNETH
Provider Middle Name:
FRANCIS
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1619941747
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/20/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5900 LAKE WRIGHT DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORFOLK
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23502-1871
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-466-8683
Provider Business Mailing Address Fax Number:
757-466-8892

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1950 GLENN MITCHELL DR
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
VIRGINIA BEACH
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23456-0019
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-368-0437
Provider Business Practice Location Address Fax Number:
757-368-0492
Provider Enumeration Date:
02/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RX0202X , with the licence number:  0101053645 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RH0003X , with the licence number: 0101053645 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: P01373557 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1619941747 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".




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