DR. JOHN TYLER CORCORAN (NPI# 1770074395) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770074395 |
| Entity Type | Individual |
| Full Name | DR. JOHN TYLER CORCORAN |
| Credential | DDS |
| Practice Address |
633d Medical Group 76 Nealy Ave, Building #92 Hampton VA 23665 |
| Mailing Address |
400 Benevita Pl Apt 308 Hampton VA 23666-3182 |
| Practice Telephone | 7572257630 |
| Mailing Telephone | 5137030014 |
| Enumeration Date | 2018-05-21 |
| Last Update Date | 2018-05-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
30.025421 | OH | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255605614 | John Joseph Corcoran | Obstetrics & Gynecology | 1849 Serene Way, Lancaster, PA 17602-7001 | 2012-03-02 |
| 1063070852 | John Corcoran | Emergency Medicine | 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712 | 2019-06-05 |
| 1053350603 | John Gregory Corcoran | Internal Medicine | 5265 E Knight Drive, Tucson Internal Medicine, Tucson, AZ 85711 | 2006-06-06 |
| 1518911361 | John Corcoran | Physical Therapist | 100 College Pkwy, Suite 100, Williamsville, NY 14221-6800 | 2006-05-19 |
| Street Address |
633D MEDICAL GROUP 76 NEALY AVE, BUILDING #92 |
| City | HAMPTON |
| State | VA |
| Zip Code | 23665 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336687870 | Nathan James Goetz | Pharmacist | 633d Medical Group, Joint Base Langley-eustis, Hampton, VA 23665-2040 | 2017-02-04 |
| 1558650127 | Son Phuong Pham | Emergency Medicine | 633d Medical Group, 77 Nealy Ave, Hampton, VA 23665-2040 | 2011-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982228938 | Mai Stern | Student in an Organized Health Care Education/Training Program | Langley Afb Dental Clinic, Hampton, VA 23665 | 2020-06-05 |
| 1386273449 | Nicholas Thomas Nelson | Military Health Care Provider | 633d Medical Group, 76 Nealy Ave, Building #92, Apo, AA 23665 | 2020-04-02 |
| 1316574809 | Kimberly C Easterling | Student in an Organized Health Care Education/Training Program | 76 Nealy Avenue, Joint Base Langley-eustis, Hampton, VA 23665 | 2020-03-24 |
| 1851950026 | Erin Leigh Baldridge | Dentist | Joint Base Langley Eustis Dental Clinic, 76 Nealy Ave, Apo, AA 23665 | 2019-06-11 |
| 1669950739 | Anthony Interrante IIi | Nurse Practitioner | Usaf Hospital Langley, 77 Nealy Avenue, Hampton, VA 23665 | 2018-08-01 |
| 1588189310 | Stacey Marie Jackson | Psychologist | 11 Nealy Blvd, Hampton, VA 23665 | 2017-08-14 |
| 1285062216 | Michael John Vietti | Physician Assistant | 633 Mdg 77 Nealy Ave, Yorktown, VA 23665 | 2013-10-30 |
| 1396182234 | Micaela Jane Dagucon | General Practice | 633d Mdg/sghc, 77 Nealy Avenue, Joint Base Langley-eustis, VA 23665 | 2013-06-02 |
| 1912212051 | Michele Leigh Shirley | Pharmacist | 633d Medical Group Hospital, 77 Nealy Avenue, Building 257, Joint Base Langley-eustis, VA 23665 | 2010-08-13 |
| 1497915219 | Stephen Warren Porter | Dentist | 76 Nealy Ave, 1st Dental Squadron/sgd, Langley Air Force Base, VA 23665 | 2008-06-16 |
| Find all providers in zip 23665 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720631187 | Justin Spiegelman | Dentist | 2040 Coliseum Dr Unit A27, Hampton, VA 23666-3200 | 2019-07-24 |
| 1891354908 | Ceonna Patrice Parran | Dentist | 1070 W Mercury Blvd, Hampton, VA 23666-3378 | 2019-06-12 |
| 1942772926 | Patrick Orme | Dentist | 76 Nealy Blvd # 92, Hampton, VA 23665-2022 | 2019-01-01 |
| 1912350547 | The Foleck Center, Ltd. | Dentist | 2400 Cunningham Dr, Suite 100, Hampton, VA 23666-6500 | 2016-07-19 |
| 1033568647 | Vikram S. Pole | Dentist | 208 Fox Hill Rd Ste B, Hampton, VA 23669-1780 | 2016-06-06 |
| 1669855011 | David Miller | Dentist | 131 Atlantic Ave, Unit B, Hampton, VA 23664-1095 | 2015-07-02 |
| 1700298676 | Jihee Woo | Dentist | 2111 Hartford Rd Ste D, Hampton, VA 23666 | 2014-05-27 |
| 1649524752 | Dental Professionals of Virginia, P.c | Dentist | 70 W Mercury Blvd Ste 102, Hampton, VA 23669-2570 | 2012-10-29 |
| 1942469291 | Emmanuel Kwesi Amoah | Dentist | 1194 Big Bethel Rd, Hampton, VA 23666-1906 | 2008-06-03 |
| 1932376308 | Dr. William B. Moore, P.C. | Dentist | 27 N Federal St, Hampton, IA 50441-1933 | 2008-05-14 |
| Find all providers in HAMPTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.