Healthcare Provider Details

I. General information

NPI: 1497309017
Provider Name (Legal Business Name): ANESTHESIA CONNECTIONS DENTAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2019
Last Update Date: 08/25/2022
Certification Date: 08/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 HUGUENOT TRL
MIDLOTHIAN VA
23113-9216
US

IV. Provider business mailing address

555 HUGUENOT TRL
MIDLOTHIAN VA
23113-9216
US

V. Phone/Fax

Practice location:
  • Phone: 804-301-4830
  • Fax: 888-831-1024
Mailing address:
  • Phone: 804-301-4830
  • Fax: 888-831-1024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. ANTHONY JOSEPH VADELLA
Title or Position: MANAGING MEMBER
Credential:
Phone: 804-301-4830