1. Home
  2. Directory
  3. Virginia
  4. Richmond
  5. Dentist
  6. NPI Profile

VCU
NPI 1073065173
Dentist - Periodontics in Richmond, VA

Active since October 25, 2016CLIA 49D0661169 · Certificate of Compliance
520 N 12TH ST, RICHMOND, VA 23298(804) 828-9190 Get Directions Write a Review

NPPES record last updated: October 25, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Vcu NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VCU (NPI 1073065173) is a healthcare organization registered as a periodontics in Richmond, Virginia and active in the NPI registry since October 2016. The organization holds a CLIA Certificate of Compliance certificate valid through April 22, 2027 and lists Thomas Waldrop, Program Director, as its authorized official.

NPPES Registry Identity

NPI1073065173
Entity TypeOrganization
Primary Taxonomy1223P0300X
Legal Business NameVCU
Location Address520 N 12TH STRichmond, VA 23298-5064
Mailing Address520 N 12th StRichmond, VA 23298-5064 · (804) 828-9190
Phone(804) 828-9190
Organization SubpartNo
Authorized OfficialThomas WaldropProgram Director · (804) 828-4867
Enumeration DateOctober 25, 2016
✔ NPI 1073065173 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers
Taxonomy Code1223P0300X
License✔ Licensed in VA · 0442000290
Definition

That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.

520 N 12TH ST, Richmond, VA 23298
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 49D0661169

Vcu Dental Care, Oral Diagnostic Services · Richmond, VA
Active · expires Apr 22, 2027
CLIA Number49D0661169
Laboratory TypeOral Path Services
Certificate Effective DateApril 23, 2025
Certificate Expiration DateApril 22, 2027
Laboratory DirectorSarah H. Glass
Laboratory Phone(804) 828-1778
Laboratory LocationVcu Dental Care, Oral Diagnostic Services520 North 12th Street Room 315 Lyons Building, Richmond, VA 23298
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. LAURIE CHILDS CARTER D.D.S.
Dentist
520 N 12TH ST, 315 LYONS BLDG.
RICHMOND, VA 23298
Richmond City (804) 828-1778
DR. BLAKE JEREMY MAXFIELD DDS
Dentist (Orthodontics and Dentofacial Orthopedics)
520 N 12TH ST
RICHMOND, VA 23298
Richmond City (804) 828-0843
DR. ALFRED JOSEPH CERTOSIMO
Dentist (General Practice)
520 N 12TH ST, P.O. 980566
RICHMOND, VA 23298
Richmond City (804) 828-9190
DR. MICHAEL HEALY DDS
Dentist (General Practice)
520 N 12TH ST
RICHMOND, VA 23298
Richmond City (804) 828-9196
DR. BRIDGET ELLEN BYRNE DDS
Dentist (Endodontics)
520 N 12TH ST, DEAN'S OFFICE ROOM 450
RICHMOND, VA 23298
Richmond City (804) 828-9184
FAWAZ AL-FORAIH DDS
Dentist (Endodontics)
520 N 12TH ST, LYONS BLDG, RM 224
RICHMOND, VA 23298
Richmond City (804) 263-7197
MANPREET S SARAO B.D.S., D.D.S.
Dentist (General Practice)
520 N 12TH ST
RICHMOND, VA 23298
Richmond City (804) 828-0784
RICHARD ANDREW HUTCHISON
Student in an Organized Health Care Education/Training Program
520 N 12TH ST
RICHMOND, VA 23298
Richmond City (804) 828-8529

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Vcu's NPI number?

The NPI number for Vcu is 1073065173. It was assigned to this organization in the NPPES registry on October 25, 2016.

Where is Vcu located?

Vcu is located at 520 N 12th St, Richmond, VA 23298. The listed phone number is (804) 828-9190.

What is Vcu's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Does Vcu hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 49D0661169) is associated with this NPI, valid through April 22, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Vcu was last updated on October 25, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.