Brickhouse, Tegwyn
Brickhouse, Tegwyn is an individual health care provider with primary practice located at 521 N 11Th St , Richmond VA 23298-5045. She recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as her primary health care specialty. Brickhouse, Tegwyn can be contacted via phone (804) 828-9095.Contact Information
Primary practice address
521 N 11Th St
Richmond VA 23298-5045
Phone: (804) 828-9095
Fax: (804) 827-1244
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | 0411000034 | Virginia |
Profile Details
| NPI number | 1285664961 |
|---|---|
| LBN Legal business name | Brickhouse, Tegwyn |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 5th, 2006 |
| Last updated | Dec 14th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1285664961 | NPPES |
| Virginia | MEDICAID | 01-0025621 | |
| Virginia | MEDICAID | 0018308 | |
| Virginia | Other | 463655 |
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