Active NPI
Sandra Altarawneh, DDS, MS
- Prosthodontics
- Richmond, VA
National Provider Identifier
1720622152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 0401418680
- Practice address
- 520 N 12TH St
Richmond, VA 23298-5064 - Phone
- (804) 628-4550
- NPI assigned
- Oct 29, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 136.000250 | IL | |
| Prosthodontics | 1223P0700X | 0401418680 | VA | Primary |
Addresses
Primary practice location
520 N 12TH St
Richmond, VA 23298-5064
Mailing address
5000 Libbie Mill East Blvd Apt 520
Richmond, VA 23230-2175
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 136.000250 | IL | MD | Prosthodontist |
| 0401418680 | VA | MD | Prosthodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vcu Dental Faculty Practice, LLC | Prosthodontics | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Richmond, VA
- NPI 1568037471
Prosthodontics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572307200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707264000000",
"number": "1720622152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5000 LIBBIE MILL EAST BLVD APT 520",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232302175"
},
{
"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": "232985064",
"telephone_number": "804-628-4550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALTARAWNEH",
"first_name": "SANDRA",
"name_prefix": "Dr.",
"credential": "DDS, MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-29",
"last_updated": "2024-02-07",
"certification_date": "2024-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "IL",
"license": "136.000250",
"primary": false
},
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "VA",
"license": "0401418680",
"primary": true
}
],
"identifiers": [],
"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 Feb 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.