Healthcare Provider Details

I. General information

NPI: 1942795307
Provider Name (Legal Business Name): RICHARD DIXON SYKES DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2018
Last Update Date: 08/05/2021
Certification Date: 08/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6353 MECHANICSVILLE TURNPIKE
MECHANICSVILLE VA
23111
US

IV. Provider business mailing address

1612 HUGUENOT ROAD
MIDLOTHIAN VA
23113
US

V. Phone/Fax

Practice location:
  • Phone: 804-730-3400
  • Fax: 804-419-1059
Mailing address:
  • Phone: 804-794-9789
  • Fax: 804-419-1059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number0401416096
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number0401416096
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: