Provider Demographics
NPI:1205687415
Name:RVO PEDIATRIC DENTISTRY PLLC
Entity type:Organization
Organization Name:RVO PEDIATRIC DENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC DENTIST - OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHREYA
Authorized Official - Middle Name:
Authorized Official - Last Name:DESAI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:804-814-8456
Mailing Address - Street 1:3400 HAYDENPARK LN STE 204
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23233-7867
Mailing Address - Country:US
Mailing Address - Phone:804-814-8456
Mailing Address - Fax:
Practice Address - Street 1:3400 HAYDENPARK LN STE 204
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23233-7867
Practice Address - Country:US
Practice Address - Phone:804-814-8456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty