Individual provider Active NPI

George Richard Deeb, D.D.S., M.D.

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Richmond, VA
National Provider Identifier
1629176185
Registry record updated Sep 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
0401413966 Issued in VA
Practice address
520 N 12TH St
Richmond, VA 23298
Phone
(804) 628-6637
Fax
(804) 827-1040
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 0401413966 VA
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 0401413966 VA Primary

Addresses

Primary practice location

520 N 12TH St
Richmond, VA 23298

Mailing address

520 N 12TH St
Richmond, VA 23298-5064
Phone (804) 628-6637

Other practice location 1

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

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
I20130826000882 VA Practitioner - Oral Surgery 1153382791 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
University of Colorado School of Medicine, Denver, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vcu Oral-Facial Surgery and Services LLCGroup PAC ID 7416349022, 7 clinicians

Practice addresses (Care Compare)

520 N 12TH St
Richmond, VA 23298-5064
Phone (804) 828-3769

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0401413966VAMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Vcu Oral-Facial Surgery and Services LLC Oral and Maxillofacial Surgery CurrentSince Aug 20, 2021 Accepting new patients
Casas Adobes Oms PLLC Oral and Maxillofacial Surgery PastSince Jul 22, 2016 Accepting new patients

Locations

1001 E Leigh St
Fl 14
Richmond, VA 23298
Phone (804) 628-4368

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

521 N 12th St
Richmond, VA 23298
Phone (804) 828-2977

1250 E Marshall St
Richmond, VA 23298
Phone (804) 628-6990

401 N 11th St
Richmond, VA 23219
Phone (804) 828-4409

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568246400000",
    "number": "1629176185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 N 12TH ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232985064",
            "telephone_number": "804-628-6637",
            "fax_number": "804-827-1040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N 12TH ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "23298",
            "telephone_number": "804-628-6637",
            "fax_number": "804-827-1040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "520 N 12th St",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "23298",
            "country_code": "US",
            "telephone_number": "804-628-6637",
            "fax_number": "804-827-1040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEEB",
        "first_name": "GEORGE",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2019-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "VA",
            "license": "0401413966",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "VA",
            "license": "0401413966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.