Provider Demographics
NPI:1124386206
Name:ADAMS AND ALLEN
Entity Type:Organization
Organization Name:ADAMS AND ALLEN
Other - Org Name:DENTISTRY FOR CHILDREN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:804-780-2888
Mailing Address - Street 1:300 W BROAD ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23220-4219
Mailing Address - Country:US
Mailing Address - Phone:804-780-2888
Mailing Address - Fax:804-643-1916
Practice Address - Street 1:300 W BROAD ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23220-4219
Practice Address - Country:US
Practice Address - Phone:804-780-2888
Practice Address - Fax:804-643-1916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-26
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010045451223P0221X
VA04014112791223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1689664427OtherNPI