| Vcu Oral-facial Surgery And Services Llc | |
|
520 N 12th St Richmond VA 23298-5064 | |
| (804) 628-6637 | |
| Not Available |
| Full Name | Vcu Oral-facial Surgery And Services Llc |
|---|---|
| Speciality | Oral & Maxillofacial Surgery |
| Location | 520 N 12th St, Richmond, Virginia |
| Authorized Official Name and Position | Sandy Kroslack (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 9042011428 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vcu Oral-facial Surgery And Services Llc 520 N 12th St Richmond VA 23298-5064 Ph: () - | Vcu Oral-facial Surgery And Services Llc 520 N 12th St Richmond VA 23298-5064 Ph: (804) 628-6637 |
| NPI Number | 1215502125 |
|---|---|
| Provider Enumeration Date | 05/24/2021 |
| Last Update Date | 07/21/2023 |
| Medicare PECOS PAC ID | 7416349022 |
|---|---|
| Medicare Enrollment ID | O20220111001814 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215502125 | NPI | - | NPPES |
| Provider Name | Robert A Strauss |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1790748770 PECOS PAC ID: 5496646796 Enrollment ID: I20040324001007 |
| Provider Name | Abubaker Omar Abubaker |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1639132749 PECOS PAC ID: 6608767942 Enrollment ID: I20040324001102 |
| Provider Name | George Richard Deeb |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1629176185 PECOS PAC ID: 1153382791 Enrollment ID: I20130826000882 |
| Provider Name | Shravan Kumar Renapurkar |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1881911600 PECOS PAC ID: 3375768948 Enrollment ID: I20150901002501 |
| Provider Name | Sarah H Glass |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1962812305 PECOS PAC ID: 6709121221 Enrollment ID: I20190102001635 |
| Provider Name | Ashraf Heram |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1598927196 PECOS PAC ID: 2163858622 Enrollment ID: I20200203000291 |
| Provider Name | Shawn P Mcmahon |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1982681771 PECOS PAC ID: 3072943182 Enrollment ID: I20200413002755 |
| Provider Name | Daniel Hawkins |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1750736922 PECOS PAC ID: 2466747415 Enrollment ID: I20201204000369 |
| Provider Name | Dan Q Tran |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1295189785 PECOS PAC ID: 5193010890 Enrollment ID: I20210104000216 |
| Provider Name | James K Vick |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1881766830 PECOS PAC ID: 3779975164 Enrollment ID: I20220114001400 |
| Provider Name | Alexandra D Howell |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1962963843 PECOS PAC ID: 1355679739 Enrollment ID: I20221229000729 |
| Provider Name | Yotom Rabinowitz |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1275037640 PECOS PAC ID: 2466708557 Enrollment ID: I20230103000444 |
| Provider Name | Alexandra G Glickman |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1508158742 PECOS PAC ID: 2860864592 Enrollment ID: I20230207000518 |
| Provider Name | Vickas Agarwal |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1164961454 PECOS PAC ID: 0941663801 Enrollment ID: I20230825001682 |
| Provider Name | Samuel Tack |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1033658406 PECOS PAC ID: 4284087941 Enrollment ID: I20240129004081 |
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