Provider Demographics
NPI:1043574759
Name:SHELDON A BATES DMD PC
Entity Type:Organization
Organization Name:SHELDON A BATES DMD PC
Other - Org Name:BATES ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHELDON
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:BATES
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:803-427-2744
Mailing Address - Street 1:3800 STILLMAN PKWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23233-1455
Mailing Address - Country:US
Mailing Address - Phone:804-934-9292
Mailing Address - Fax:804-934-9290
Practice Address - Street 1:3800 STILLMAN PKWY
Practice Address - Street 2:SUITE 101
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23233-1455
Practice Address - Country:US
Practice Address - Phone:804-934-9292
Practice Address - Fax:804-934-9290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-27
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014134951223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty