Healthcare Provider Details

I. General information

NPI: 1326726712
Provider Name (Legal Business Name): AKUA OWUSU-DOMMEY DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2023
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 E BROAD ST FL 6
RICHMOND VA
23219-1930
US

IV. Provider business mailing address

823 E MAIN ST APT 221
RICHMOND VA
23219-3309
US

V. Phone/Fax

Practice location:
  • Phone: 804-828-9095
  • Fax:
Mailing address:
  • Phone: 480-324-6605
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number0401419850
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: