Healthcare Provider Details

I. General information

NPI: 1770405367
Provider Name (Legal Business Name): RICHMOND CHILDREN'S GENERAL ANESTHESIA DENTISTRY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5899 BREMO RD STE 204
RICHMOND VA
23226-1935
US

IV. Provider business mailing address

5899 BREMO RD STE 204
RICHMOND VA
23226-1935
US

V. Phone/Fax

Practice location:
  • Phone: 804-806-4381
  • Fax:
Mailing address:
  • Phone: 804-806-4381
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JEFFERY WHEELER
Title or Position: CEO
Credential:
Phone: 301-494-3000