Healthcare Provider Details

I. General information

NPI: 1013058767
Provider Name (Legal Business Name): CLAIRE C KAUGARS DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5700 OLD RICHMOND AVE STE. C-14
RICHMOND VA
23226-1828
US

IV. Provider business mailing address

5700 OLD RICHMOND AVE STE. C-14
RICHMOND VA
23226-1828
US

V. Phone/Fax

Practice location:
  • Phone: 804-285-4867
  • Fax: 804-282-2453
Mailing address:
  • Phone: 804-285-4867
  • Fax: 804-282-2453

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number0401005790
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: