Provider Demographics
NPI:1689664427
Name:ADAMS, RANDY (DDS)
Entity Type:Individual
Prefix:DR
First Name:RANDY
Middle Name:
Last Name:ADAMS
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 1:300 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
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA45451223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry