RENITA WALDEN RANDOLPH (NPI# 1851422331) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851422331 |
| Entity Type | Individual |
| Full Name | RENITA WALDEN RANDOLPH |
| Credential | D.D.S. |
| Practice Address |
11551 Nuckols Rd Suite A Glen Allen VA 23059-5565 |
| Mailing Address |
13292 Kenwick Ct Richmond VA 23238-6446 |
| Practice Telephone | 8042736818 |
| Practice Fax Number | 8042730347 |
| Mailing Telephone | 8043172227 |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 0401007596 | VA | Dental Providers |
| Street Address |
11551 NUCKOLS RD SUITE A |
| City | GLEN ALLEN |
| State | VA |
| Zip Code | 23059-5565 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255424206 | Keith Andrew Derco | Pediatrics | 11551 Nuckols Rd, Suite F, Glen Allen, VA 23059-5565 | 2006-10-02 |
| 1497382378 | Taylor Delaine Zuchowski | Dietitian, Registered | 11551 Nuckols Rd, Glen Allen, VA 23059-5565 | 2020-03-23 |
| 1407232770 | Short Pump Wellness Clinic, LLC | Family Medicine | 11551 Nuckols Rd, Suite C, Glen Allen, VA 23059-5565 | 2015-08-10 |
| 1316324726 | Christina Wical | Nurse Practitioner | 11551 Nuckols Rd, Suite C, Glen Allen, VA 23059-5565 | 2015-05-05 |
| 1417388588 | Associates In Pediatrics | Pediatrics | 11551 Nuckols Rd, Suite F, Glen Allen, VA 23059-5565 | 2013-11-27 |
| 1831459080 | Joanne Sylvia Lane | Pediatrics | 11551 Nuckols Rd, Suite F, Glen Allen, VA 23059-5565 | 2012-05-22 |
| 1871749655 | Respiratory Specialties Company Lc | Durable Medical Equipment & Medical Supplies | 11551 Nuckols Rd, Suite N, Glen Allen, VA 23059-5565 | 2008-08-13 |
| 1235320854 | Helen Habtemichael | Nurse Practitioner | 11551 Nuckols Rd, Suite C, Glen Allen, VA 23059-5565 | 2007-08-08 |
| 1841413184 | Dominion Behavioral Healthcare | Counselor | 11551 Nuckols Rd, Suite F, Glen Allen, VA 23059-5565 | 2007-04-11 |
| 1225155781 | Associates In Pediatrics | Pediatrics | 11551 Nuckols Rd, Suite F, Glen Allen, VA 23059-5565 | 2007-03-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003422163 | Kusum Bhetwal | Nurse Practitioner | 12804 Westin Estates Drive, Glen Allen, VA 23059 | 2020-09-23 |
| 1538704770 | Rise Services LLC | Community/Behavioral Health | 11357 Nuckois Road, Suite 2043, Glen Allen, VA 23059 | 2019-11-12 |
| 1992347116 | Irene Anne Mcgovern | Technician | 5233 Eastbranch Dr, Glen Allen, VA 23059 | 2019-10-09 |
| 1427547322 | Sharon Ann Lott | Audiologist | Short Pump Middle School, 4701 Pouncey Tract Road, Glen Allen, VA 23059 | 2018-05-07 |
| 1518476423 | Thomas Joseph Stein | Pharmacist | 4912 Old Millrace Place, Glen Allen, VA 23059 | 2017-09-22 |
| 1033638440 | Caroline Taylor | Specialist/Technologist | 5143 Dorin Hill Ct., Glen Allen, VA 23059 | 2017-09-18 |
| 1003335167 | Rva Transport, Inc. | Non-emergency Medical Transport (VAN) | 830 Brassie Ln, Apt F, Glen Allen, VA 23059 | 2017-09-10 |
| 1639628407 | Jessica Jasmine Green | Nurse Practitioner | 4687 Poucey Tract Road, Glen Allen, VA 23059 | 2016-09-22 |
| 1255512760 | Peggy Ellen York | Psychologist | 13314 Greenwood Rd, Glen Allen, VA 23059 | 2007-11-27 |
| 1689795940 | Kim Blassic | Dentist | 5225 Hickory Park Dr., Suite D, Glen Allen, VA 23059 | 2007-04-03 |
| Find all providers in zip 23059 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750733838 | Vinny Karia | Dentist | 2450 Old Brick Rd Apt 1434, Glen Allen, VA 23060-6000 | 2016-07-12 |
| 1922408194 | Hendrick B. Tafo-tabue, Dds, PC | Dentist | 12201 Tiverton Ln, Glen Allen, VA 23059-7015 | 2014-08-25 |
| 1679853063 | Myungsuk Koh | Dentist | 302 Jamerson Ct, Glen Allen, VA 23059-5678 | 2011-08-17 |
| 1922267640 | Anne Carter Adams | Dentist | 10127 West Broad Street, Suite Q, Glen Allen, VA 23060 | 2008-06-06 |
| 1720265820 | Bradley Richard Anderson | Dentist | 11420 W Broad Street, Glen Allen, VA 23060 | 2008-01-31 |
| 1669650750 | Surya P. Dhakar, D.d.s., P.C. | Dentist | 4440 Springfield Rd Ste 101, Glen Allen, VA 23060-3410 | 2008-01-31 |
| 1962522839 | Clinton J. Norris, D.d.s., P.C. | Dentist | 4445 Cox Rd, Glen Allen, VA 23060-3326 | 2007-04-01 |
| 1215072459 | Farshid Soltanian | Dentist | 3944 Springfield Rd, Glen Allen, VA 23060-4119 | 2007-02-21 |
| 1245382878 | Steven K Larkin | Dentist | 10212 Staples Mill Road, Glen Allen, VA 23060 | 2007-01-16 |
| 1922169432 | Steven T Bunn | Dentist | 4701 Cox Rd Ste 285, Glen Allen, VA 23060-6808 | 2006-12-12 |
| Find all providers in GLEN ALLEN | ||||
| City | GLEN ALLEN |
| Zip Code | 23059 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.