Individual provider Active NPI

Duane Robert Schafer, DDS

  • Oral and Maxillofacial Pathology Dentistry
  • Richmond, VA
National Provider Identifier
1043211899
Registry record updated Jan 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
License
041412314 Issued in VA
Practice address
520 N 12TH St RM 315
Richmond, VA 23298-5064
Phone
(804) 828-5687
Fax
(804) 828-6234
NPI assigned
Aug 2, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Pathology Dentistry 1223P0106X DS0000010158 TN
Oral and Maxillofacial Pathology Dentistry 1223P0106X DSO23468L PA
Oral and Maxillofacial Pathology Dentistry 1223P0106X 041412314 VA Primary

Addresses

Primary practice location

520 N 12TH St RM 315
Richmond, VA 23298-5064

Mailing address

PO Box 8887
Greenville, TX 75404-8887
Phone (254) 212-1253

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190221002674 VA Practitioner - Oral Surgery 2860731676 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DSO23468LPAMDOral and Maxillofacial Pathology Dentist
DS0000010158TNMDOral and Maxillofacial Pathology Dentist
041412314VAMDOral and Maxillofacial Pathology Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Vcu Diagnostic Services LLC Oral and Maxillofacial Pathology CurrentSince Jan 2, 2019 Accepting new patients

Locations

520 N 12th St
Rm 315
Richmond, VA 23298
Phone (804) 828-5687

520 N 12th St
Ste 315
Richmond, VA 23298
Phone (804) 828-1778

520 N 12th St
Richmond, VA 23298
Phone (804) 628-6637

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548892800000",
    "number": "1043211899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8887",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754048887",
            "telephone_number": "254-212-1253",
            "fax_number": "866-399-2814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N 12TH ST RM 315",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232985064",
            "telephone_number": "804-828-5687",
            "fax_number": "804-828-6234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAFER",
        "first_name": "DUANE",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2019-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "TN",
            "license": "DS0000010158",
            "primary": false
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "PA",
            "license": "DSO23468L",
            "primary": false
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "VA",
            "license": "041412314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.