| Virginia Total Sleep Pllc | |
|
10120 W Broad St Ste I Glen Allen VA 23060-6709 | |
| (804) 625-4064 | |
| (804) 625-4066 |
| Full Name | Virginia Total Sleep Pllc |
|---|---|
| Speciality | Dentist |
| Location | 10120 W Broad St Ste I, Glen Allen, Virginia |
| Authorized Official Name and Position | Alexander Thomas Vaughan (OWNER) |
| Authorized Official Contact | 8046254064 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Virginia Total Sleep Pllc 10120 W Broad St Ste I Glen Allen VA 23060-6709 Ph: (804) 625-4064 | Virginia Total Sleep Pllc 10120 W Broad St Ste I Glen Allen VA 23060-6709 Ph: (804) 625-4064 |
| NPI Number | 1235695743 |
|---|---|
| Provider Enumeration Date | 02/20/2019 |
| Last Update Date | 03/30/2023 |
| Medicare PECOS PAC ID | 9638410186 |
|---|---|
| Medicare Enrollment ID | O20190409003477 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235695743 | NPI | - | NPPES |
| Provider Name | Alexander Thomas Vaughan |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1992147599 PECOS PAC ID: 0143588301 Enrollment ID: I20171215000590 |
| Provider Name | Michael Stephen Pagano |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1275910978 PECOS PAC ID: 6901147453 Enrollment ID: I20200507003110 |
| Provider Name | Shahrzad Orenduff |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1003229733 PECOS PAC ID: 0446540926 Enrollment ID: I20220114001692 |
| Provider Name | Jennifer Huffman |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1114017381 PECOS PAC ID: 1850622069 Enrollment ID: I20230512001210 |
| Provider Name | Rodney A Mcdaniel |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1023277720 PECOS PAC ID: 1153776760 Enrollment ID: I20231017000088 |
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