Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

VCU

Organization Periodontics · NPI 1073065173

VCU provides Periodontics in Richmond, Virginia. Licensed in Virginia. Registered with an NPI since 2016.

Licensed in
VA
In the registry since
2016

Practice location Address checks out

520 N 12th St
Richmond, VA 23298-5064 Not confirmed with CMS for 10 years — call before visiting
Phone: (804) 828-9190
Show map & directions

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

Specialties & licences

Periodontics (primary) Taxonomy 1223P0300X · Licence 0442000290 (VA)

Record details

NPI number1073065173
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Thomas Waldrop — Program Director · (804) 828-4867
NPI enumeratedOctober 25, 2016
Last updated in NPPESOctober 25, 2016
Mailing address520 N 12th St, Richmond, VA 23298-5064

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