Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Coastal Pediatric Dental & Anesthesia, PLLC

Organization Dentist · NPI 1184155962

Coastal Pediatric Dental & Anesthesia, PLLC is a Dentist in Norfolk, Virginia. Licensed in Virginia. Registered with an NPI since 2017.

Licensed in
VA
In the registry since
2017
Specialties on file
3
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

6161 Kempsville Cir Ste 345
Norfolk, VA 23502-3932
Phone: (602) 799-1748
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dental Anesthesiology (primary) Taxonomy 1223D0004X · Licence 0447000045 (VA)
Dentist Taxonomy 122300000X · Licence 0401414467 (VA)
Pediatric Dentistry Taxonomy 1223P0221X · Licence 0401413751 (VA)

Record details

NPI number1184155962
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jonathan Wong — Owner · (757) 963-0001
Other names Coastal Pediatric Dental & Anesthesia; Jillian Reynolds, Dds & Jonathan L Wong, Dmd , Pllc
NPI enumeratedMarch 23, 2017
Last updated in NPPESMarch 24, 2026
Certification dateMarch 24, 2026
Mailing address303 55th St Unit A, Virginia Beach, VA 23451-2213

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