Unknown Individual – Periodontics, NPI 1013069640

Unknown Individual is a healthcare provider. based in Midlothian, Virginia. specializing in Periodontics. They hold a License No. 0401004731 (VA). The NPI Number for Unknown Individual is 1013069640

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1013069640
Phone
(804) 794-9789
Address
1612 HUGUENOT ROAD
Deactivation Date
6 March 2024
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 1612, Huguenot Road, Olde Coach Village, North Chesterfield, Midlothian, Chesterfield County, Virginia, 23113, United States

    MIDLOTHIAN, VA 23113

    Phone: (804) 794-9789

    Fax: (804) 794-9762

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 23113)

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Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1013069640?
NPI 1013069640 belongs to Unknown Individual; compare other details if you need extra assurance.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Periodontics. Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Midlothian, Virginia as the reference point for Unknown Individual, then confirm.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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