NPIMap

Organization Active NPI

River Run Dental of Libbie Mill, PLLC

  • General Practice Dentistry
  • Richmond, VA
National Provider Identifier
1720795131
Registry record updated Nov 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
RIVER RUN DENTAL OF LIBBIE MILL, PLLC
Practice address
5001 Libbie Mill East Blvd Ste 125
Richmond, VA 23230-2152
Phone
(804) 390-7133
NPI assigned
Nov 4, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2022

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X

Addresses

Primary practice location

5001 Libbie Mill East Blvd Ste 125
Richmond, VA 23230-2152

Mailing address

5001 Libbie Mill East Blvd Ste 125
Richmond, VA 23230-2152
Phone (804) 390-7133

Other names 1

  • River Run Dental Doing business as

National Provider Directory

National Provider Directory

Locations

5001 Libbie Mill East Blvd
Ste 125
Richmond, VA 23230
Phone (804) 390-7133

Practitioners & affiliated clinicians

Practitioners 6

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": "1667520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667520000000",
    "number": "1720795131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 LIBBIE MILL EAST BLVD STE 125",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232302152",
            "telephone_number": "804-390-7133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 LIBBIE MILL EAST BLVD STE 125",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232302152",
            "telephone_number": "804-390-7133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER RUN DENTAL OF LIBBIE MILL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-04",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "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": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "River Run Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 4, 2022; 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.