Healthcare Provider Details

I. General information

NPI: 1356704258
Provider Name (Legal Business Name): VIRGINIA SLEEP & TMJ THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2016
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8730 STONY POINT PKWY SUITE 240
RICHMOND VA
23235-1970
US

IV. Provider business mailing address

8730 STONY POINT PKWY SUITE 240
RICHMOND VA
23235-1970
US

V. Phone/Fax

Practice location:
  • Phone: 804-729-3474
  • Fax: 804-729-3480
Mailing address:
  • Phone: 804-729-3474
  • Fax: 804-729-3480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number0401411855
License Number StateVA

VIII. Authorized Official

Name: DR. REBECCA ANGUS
Title or Position: DENTIST/OWNER
Credential: DDS
Phone: 804-729-3474