Provider Demographics
NPI:1497443436
Name:VIRGINIA OROFACIAL PAIN AND SLEEP CENTER
Entity Type:Organization
Organization Name:VIRGINIA OROFACIAL PAIN AND SLEEP CENTER
Other - Org Name:VIRGINIA OROFACIAL PAIN & SLEEP CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISHNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOPISETTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-335-0599
Mailing Address - Street 1:5352 TWIN HICKORY RD
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-5682
Mailing Address - Country:US
Mailing Address - Phone:408-306-6556
Mailing Address - Fax:
Practice Address - Street 1:5352 TWIN HICKORY RD
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23059-5682
Practice Address - Country:US
Practice Address - Phone:408-306-6556
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty