VCU ORAL-FACIAL SURGERY AND SERVICES LLC
NPI 1215502125
Oral & Maxillofacial Surgery in Richmond, VA

Active since May 24, 2021
520 N 12TH ST, RICHMOND, VA 23298(804) 628-6637 Get Directions Write a Review

NPPES record last updated: July 21, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 21, 2023, Aug 30, 2022, May 24, 2021 (3 updates tracked since 2021).

About Vcu Oral-facial Surgery And Services Llc NPPES

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

VCU ORAL-FACIAL SURGERY AND SERVICES LLC (NPI 1215502125) is a healthcare organization registered as an oral & maxillofacial surgery in Richmond, Virginia and active in the NPI registry since May 2021. The organization maintains 3 additional practice locations and lists Sandy Kroslack, Credentialing Specialist, as its authorized official.

NPPES Registry Identity

NPI1215502125
Entity TypeOrganization
Primary Taxonomy204E00000X
Legal Business NameVCU ORAL-FACIAL SURGERY AND SERVICES LLC
Location Address520 N 12TH STRichmond, VA 23298-5064
Mailing Address520 N 12th StRichmond, VA 23298-5064
Organization SubpartYesParent: Dentistry Vcu
Authorized OfficialSandy KroslackCredentialing Specialist · (904) 201-1428
Enumeration DateMay 24, 2021
Last NPPES UpdateJuly 21, 20233 updates tracked since enumeration
NPPES CertifiedJuly 21, 2023
✔ NPI 1215502125 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyOral & Maxillofacial SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code204E00000X
Definition
Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.
Also ListedDentist · General PracticeTaxonomy 1223G0001X
Also ListedDentist · Oral and Maxillofacial PathologyTaxonomy 1223P0106X
Also ListedDentist · Oral and Maxillofacial SurgeryTaxonomy 1223S0112X
Also ListedDentist · Orofacial PainTaxonomy 1223X2210X
520 N 12TH ST, Richmond, VA 23298

Secondary Practice Locations 3

Location 1521 N 11th StRichmond, VA 23298-5016 · Phone (804) 628-6637
Location 21001 E Leigh StRichmond, VA 23298-5004 · Phone (804) 628-6637
Location 31250 E Marshall StRichmond, VA 23298-5023 · Phone (804) 628-6637

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Vcu Oral-facial Surgery And Services Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by January 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateVirginiaEnrollment IDO20220111001814Non-DME Part B · Clinic/Group PracticeDue dateJanuary 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

16

Medicare enrollment records show 16 clinicians reassign Medicare billing to Vcu Oral-Facial Surgery And Services LLC, which bills Medicare for the services they deliver. Of these, 8 practice at this address and 12 within 10 miles. They are listed nearest first.

Clinicians by Medicare Specialty 3

Dentist7
Oral Surgery7
Maxillofacial Surgery2

Clinicians, nearest first (16)

Oral Surgery
NPI 1629176185
520 N 12TH ST
Richmond, VA 23298
(804) 628-6637
✔ PECOS✔ Accepts MedicareSame address
Dentist
NPI 1962812305
520 NORTH 12TH STREET SUITE 315
Richmond, VA 23298
(804) 828-1778
✔ PECOS✔ Accepts MedicareSame address
Dentist
NPI 1962963843
520 N 12TH ST # 980566
Richmond, VA 23298
(804) 628-0310
✔ PECOS✔ Accepts MedicareSame address
Oral Surgery
NPI 1033797600
520 N 12TH ST # 238
Richmond, VA 23298
(804) 628-6637
✔ PECOSSame address
Oral Surgery
NPI 1033658406
520 N 12TH ST
Richmond, VA 23298
(804) 628-7146
✔ PECOSSame address
Dentist
NPI 1982681771
521 N 11TH ST
Richmond, VA 23298
(804) 828-9363
✔ PECOS✔ Accepts MedicareSame address
Dentist
NPI 1508158742
521 N 11TH ST FL 3
Richmond, VA 23298
(804) 628-6637
✔ PECOSSame address
Oral Surgery
NPI 1275037640
521 N 11TH ST RM 311
Richmond, VA 23298
(804) 828-3584
✔ PECOS✔ Accepts MedicareSame address
Dentist
NPI 1295189785
1250 E MARSHALL ST BOX 980566
Richmond, VA 23298
(804) 628-6637
✔ PECOS0.1 mi
Maxillofacial Surgery
NPI 1639132749
520 N 12TH ST
Richmond, VA 23219
(804) 828-4249
✔ PECOS✔ Accepts Medicare1.6 mi
Maxillofacial Surgery
NPI 1790748770
520 N 12TH ST
Richmond, VA 23219
(804) 828-4249
✔ PECOS✔ Accepts Medicare1.6 mi
Oral Surgery
NPI 1164961454
8503 PATTERSON AVE STE A
Richmond, VA 23229
(804) 354-1600
✔ PECOS8.2 mi
Dentist
NPI 1881766830
1222 JEFFERSON PARK AVE
Charlottesville, VA 22903
(434) 924-1774
✔ PECOS✔ Accepts Medicare68 mi
Dentist
NPI 1750736922
3501 TERRACE STREET SUITE 3189
Pittsburgh, PA 15261
(412) 648-9100
✔ PECOS✔ Accepts Medicare242 mi
Oral Surgery
NPI 1598927196
920 DOUG WHITE DR STE 430
Myrtle Beach, SC 29572
(843) 903-6459
✔ PECOS✔ Accepts Medicare277 mi
Oral Surgery
NPI 1881911600
1365 CLIFTON RD NE STE 2300
Atlanta, GA 30322
(404) 778-4733
✔ PECOS✔ Accepts Medicare466 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Oral-Facial Surgery And Services LLC's NPI number?

The NPI number for Vcu Oral-Facial Surgery And Services LLC is 1215502125. It was assigned to this organization in the NPPES registry on May 24, 2021.

Where is Vcu Oral-Facial Surgery And Services LLC located?

Vcu Oral-Facial Surgery And Services LLC is located at 520 N 12th St, Richmond, VA 23298. The listed phone number is (804) 628-6637.

What is Vcu Oral-Facial Surgery And Services LLC's specialty?

The primary specialty registered for this NPI is Oral & Maxillofacial Surgery with taxonomy code 204E00000X.

Is Vcu Oral-Facial Surgery And Services LLC enrolled in Medicare?

Yes. Vcu Oral-Facial Surgery And Services LLC is registered in the Medicare PECOS enrollment system.

When is Vcu Oral-Facial Surgery And Services LLC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Virginia, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Vcu Oral-Facial Surgery And Services LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 16 clinicians in 3 Medicare specialties reassign their Medicare billing to Vcu Oral-Facial Surgery And Services LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Dentist (7), Oral Surgery (7) and Maxillofacial Surgery (2). Of these, 8 practice at this address and 12 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Vcu Oral-Facial Surgery And Services LLC accept?

Health plans from DentaQuest and UnitedHealthcare list Vcu Oral-Facial Surgery And Services LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Vcu Oral-Facial Surgery And Services LLC was last updated on July 21, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.