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

Kenneth J. Cavallari, DDS, PC

Organization Periodontics · NPI 1164305421

Kenneth J. Cavallari, DDS, PC is a Periodontics in Virginia Beach, Virginia. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

984 First Colonial Rd Ste 300
Virginia Beach, VA 23454-3196
Phone: (757) 412-0235
Fax: (757) 381-7123
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Periodontics (primary) Taxonomy 1223P0300X

Record details

NPI number1164305421
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jenny Garcia-Rocha — Sr Credentialing Team Lead · (972) 869-3789
Other names Tidewater Laser Perio & Implants
NPI enumeratedJuly 25, 2025
Last updated in NPPESJuly 25, 2025
Certification dateJuly 25, 2025
Mailing address984 First Colonial Rd Ste 300, Virginia Beach, VA 23454-3196

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