Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 2901022515 | MI |
Y | 1223G0001X | General Practice | 0401417708 | VA |
Y | 213EG0000X | General Practice | 0401417708 | VA |
N | 1223G0001X | General Practice | 9775 | NC |
N | 213EG0000X | General Practice | 9775 | NC |
NPI | 1003229733 |
---|---|
Provider Name | Dr. Shahrzad Orenduff |
First Address | Richmond, VA 23230-2115 |
Second Address | Richmond, VA 23298-5064 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2014 |
Last Update Date | 15/12/2021 |