Provider Demographics
NPI:1043625510
Name:DIX, THOMAS JAMES (DDS)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:JAMES
Last Name:DIX
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2821 N PARHAM RD STE 102
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23294-4412
Mailing Address - Country:US
Mailing Address - Phone:804-270-4397
Mailing Address - Fax:804-747-9709
Practice Address - Street 1:2821 N PARHAM RD STE 102
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23294-4412
Practice Address - Country:US
Practice Address - Phone:804-270-4397
Practice Address - Fax:804-747-9709
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-24
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014151351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty