Rossano N Wlodawsky, DDS

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

0438000187 Issued in VA

Practice address

11319 Polo PL
Midlothian, VA 23113-1434

Phone

(804) 794-0794

Fax

(804) 379-2858

NPI assigned

Mar 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533168000000",
    "number": "1174584981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11545A NUCKOLS ROAD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230595666",
            "telephone_number": "804-673-8061",
            "fax_number": "804-673-5644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11319 POLO PL",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231131434",
            "telephone_number": "804-794-0794",
            "fax_number": "804-379-2858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WLODAWSKY",
        "first_name": "ROSSANO",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2018-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "VA",
            "license": "0401410693",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "VA",
            "license": "0438000187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wisdom Care
• Douglas William Wisor, MD
• Victoria E Witt, DO
• Timothy James Wittenauer
• Megan Leigh Wittenberg, OT/L
• Laura Wojdyla
• Markita Wolf, PSY.D.
• Jennifer Wolfgang, DO
• Kayla Hokunani Womack
• Women'S Health First, PLLC

• Oral & Maxillofacial Surgery (D.M.D.) in Midlothian, VA
• Providers in Midlothian, VA by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2018; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.