Active NPI
William O Dahlke Jr., DMD
- Pediatric Dentistry
- Richmond, VA
National Provider Identifier
1548334071
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 0401414611
- Practice address
- 2560 Gaskins Rd
Richmond, VA 23238-1468 - Phone
- (804) 741-2226
- NPI assigned
- Nov 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 0401414611 | VA | Primary |
Addresses
Primary practice location
2560 Gaskins Rd
Richmond, VA 23238-1468
Mailing address
2560 Gaskins Rd
Richmond, VA 23238-1468
Phone (804) 741-2226
Other practice location 1
6169 S Rainbow Blvd
Ste 100
Las Vegas, NV 89118-3230
Phone (702) 658-6700
Other practice location 2
521 N 11th St Ste 305
Richmond, VA 23298
Phone (804) 628-4036
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100510130 | Medicaid | NV |
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
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250805003430 | VA | Order and Referring Only - Dentist | 4688182199 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620086400000",
"number": "1548334071",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2560 GASKINS RD",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232381468",
"telephone_number": "804-741-2226"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2560 GASKINS RD",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232381468",
"telephone_number": "804-741-2226"
}
],
"practiceLocations": [
{
"address_1": "6169 S Rainbow Blvd",
"address_2": "Ste 100",
"address_purpose": "LOCATION",
"city": "Las Vegas",
"state": "NV",
"postal_code": "891183230",
"country_code": "US",
"telephone_number": "702-658-6700",
"fax_number": "702-450-6711",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "521 N 11th St Ste 305",
"address_purpose": "LOCATION",
"city": "Richmond",
"state": "VA",
"postal_code": "23298",
"country_code": "US",
"telephone_number": "804-628-4036",
"fax_number": "702-450-6711",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAHLKE",
"first_name": "WILLIAM",
"middle_name": "O",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-17",
"last_updated": "2021-05-04",
"certification_date": "2021-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "VA",
"license": "0401414611",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100510130",
"state": "NV"
}
],
"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 May 4, 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.