NPIMap

Organization Active NPI

River Run Dental of Short Pump, PLLC

  • Dentist
  • Henrico, VA
National Provider Identifier
1326701368
Registry record updated Oct 18, 2021
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Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
RIVER RUN DENTAL OF SHORT PUMP, PLLC
Practice address
3400 Haydenpark LN Ste 203
Henrico, VA 23233-7867
Phone
(804) 262-1060
NPI assigned
Oct 18, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2021

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

Authorized official

Name
Chad Hendricks
Title
Credentialing
Phone
(612) 859-0444

Specialties & licenses 1

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

Addresses

Primary practice location

3400 Haydenpark LN Ste 203
Henrico, VA 23233-7867

Mailing address

3400 Haydenpark LN Ste 203
Henrico, VA 23233-7867

National Provider Directory

National Provider Directory

Locations

3400 Haydenpark Ln
Ste 203
Richmond, VA 23233
Phone (804) 262-1060

Practitioners & affiliated clinicians

Practitioners 7

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": "1634515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634515200000",
    "number": "1326701368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 HAYDENPARK LN STE 203",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232337867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 HAYDENPARK LN STE 203",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232337867",
            "telephone_number": "804-262-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER RUN DENTAL OF SHORT PUMP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-18",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A",
        "authorized_official_last_name": "HENDRICKS",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "612-859-0444"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henrico, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2021; 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.