Provider Demographics
NPI:1598014284
Name:SHORT PUMP ORTHODONTICS, PC
Entity Type:Organization
Organization Name:SHORT PUMP ORTHODONTICS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:ANDRIANA
Authorized Official - Last Name:SACHNO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MSD
Authorized Official - Phone:757-621-7698
Mailing Address - Street 1:7314 THREE CHOPT RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-3717
Mailing Address - Country:US
Mailing Address - Phone:757-621-7698
Mailing Address - Fax:
Practice Address - Street 1:3438 LAUDERDALE DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23233-7528
Practice Address - Country:US
Practice Address - Phone:757-621-7698
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-10
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401410632261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental