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

VCU

Organization Periodontics · NPI 1073065173

VCU is a 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
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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