Organization · Type 2 NPI

Coastal Pediatric Dental & Anesthesia, A Division of Atlantic Dental Care

Dentist · Norfolk, VA

NPI number 1639936172 Active

Practice location

6161 Kempsville Cir Ste 345
Norfolk, VA 23502-3950

Fax (757) 961-9988

Specialties and licenses

Taxonomy	Code	License
Dentist Primary	122300000X	None listed
Dental Anesthesiology	1223D0004X	None listed
General Practice Dentistry	1223G0001X	None listed
Pediatric Dentistry	1223P0221X	None listed

Dentist: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requiremen…

3 other providers at this address

Other dentist providers in Norfolk

See all in Norfolk →

NPI record

NPI: 1639936172
Entity type: Organization (Type 2)
Issued: Mar 1, 2024
Last updated: Oct 22, 2026
Status: Active
Subpart: Yes of Atlantic Dental Care, PLC

Other names

Coastal Pediatric Dental & Anesthesia · doing business as
Jillian Reynolds DDS & Jonathan L Wong, DMD Pllc, A Division of Atlantic Dental Care · former legal business name

Authorized official

Jonathan L Wong, DMD
Dentist
(757) 963-0001

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

Is this your record? How to update it.

About NPI 1639936172

Coastal Pediatric Dental & Anesthesia, A Division of Atlantic Dental Care's National Provider Identifier is 1639936172, issued on Mar 1, 2024. The primary taxonomy on file is Dentist (122300000X), and the practice location is in Norfolk, VA. The record was last updated on Oct 22, 2026.