NPIMap

Organization Active NPI

Dr. Eugene a. Richardson III

  • Dentist
  • Petersburg, VA
National Provider Identifier
1184894404
Registry record updated Mar 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401005258 Issued in VA
Legal business name
DR. EUGENE A. RICHARDSON III
Practice address
23 Shore St
Petersburg, VA 23803-5818
Phone
(804) 861-5331
Fax
(804) 861-5351
NPI assigned
Mar 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2008

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

Authorized official

Name
Dr. Eugene Arthur Richardson IIINPI 1396842282
Title
Dentist
Phone
(804) 861-5330

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 0401005258 VA Primary

Addresses

Primary practice location

23 Shore St
Petersburg, VA 23803-5818

Mailing address

23 Shore St
Petersburg, VA 23803-5818
Phone (804) 861-5331

Other identifiers 4

IdentifierTypeStateIssuer
9178831MedicaidVA
003363OtherVAANTHEM
691160OtherPAUNITED CONCORDIA
4066921OtherTNBC/BS

National Provider Directory

National Provider Directory

Locations

23 Shore St
Petersburg, VA 23803
Phone (804) 861-5331

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1204502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204502400000",
    "number": "1184894404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 SHORE ST",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238035818",
            "telephone_number": "804-861-5331",
            "fax_number": "804-861-5351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 SHORE ST",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238035818",
            "telephone_number": "804-861-5331",
            "fax_number": "804-861-5351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. EUGENE A. RICHARDSON III",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-03",
        "last_updated": "2008-03-03",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_middle_name": "ARTHUR",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "804-861-5330",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401005258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9178831",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "003363",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "691160",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "4066921",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Petersburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.