Active NPI
Shahrzad Orenduff, D.D.S.
- General Practice Dentistry
- Richmond, VA
National Provider Identifier
1003229733
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 0401417708
- Practice address
- 520 N 12TH St
Richmond, VA 23298-5064 - Phone
- (804) 828-9190
- NPI assigned
- Jun 10, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901022515 | MI | |
| General Practice Dentistry | 1223G0001X | 9775 | NC | |
| General Practice Dentistry | 1223G0001X | 0401417708 | VA | Primary |
Addresses
Primary practice location
520 N 12TH St
Richmond, VA 23298-5064
Mailing address
5000 Libbie Mill East Blvd Apt 173
Richmond, VA 23230-2115
Phone (757) 810-0373
Other practice location 1
15 Rawls Rd
Suite 100
Angier, NC 27501-6033
Phone (919) 639-0264 ext. 10
Other practice location 2
21055 E 12 Mile Rd
Roseville, MI 48066-2205
Phone (586) 772-0100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901022515 | MI | MD | Dentist |
| 9775 | NC | MD | General Practice Dentistry |
| 0401417708 | VA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Virginia Total Sleep PLLC | Dentist | Current | Accepting new patients |
| Virginia Total Sleep PLLC | Dentist | Current | Accepting new patients |
| Wdwrosevillepllc | General Practice | Past | Accepting new patients |
| Carl Papa D.D.S., P.C. | Dentist | Past | Accepting new patients |
Locations
10120 W Broad St
Ste I
Glen Allen, VA 23060
Phone (804) 625-4064
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dentist
- Glen Allen, VA
- NPI 1235695743
-
- Dentist
- Midlothian, VA
- NPI 1497459564
-
- Dentist
- Roseville, MI
- NPI 1114193208
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402358400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639526400000",
"number": "1003229733",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5000 LIBBIE MILL EAST BLVD APT 173",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232302115",
"telephone_number": "757-810-0373"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 N 12TH ST",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232985064",
"telephone_number": "804-828-9190"
}
],
"practiceLocations": [
{
"address_1": "15 Rawls Rd",
"address_2": "Suite 100",
"address_purpose": "LOCATION",
"city": "Angier",
"state": "NC",
"postal_code": "275016033",
"country_code": "US",
"telephone_number": "919-639-0264 x10",
"fax_number": "919-331-0239",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "21055 E 12 Mile Rd",
"address_purpose": "LOCATION",
"city": "Roseville",
"state": "MI",
"postal_code": "480662205",
"country_code": "US",
"telephone_number": "586-772-0100",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ORENDUFF",
"first_name": "SHAHRZAD",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-10",
"last_updated": "2021-12-15",
"certification_date": "2021-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901022515",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NC",
"license": "9775",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "VA",
"license": "0401417708",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Richmond, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.