Basic Information
Provider Information
NPI: 1851443485
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CRICHTON
FirstName: JAMES
MiddleName: S
NamePrefix:  
NameSuffix: JR.
Credential: DDS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1612 HUGUENOT ROAD
Address2:  
City: MIDLOTHIAN
State: VA
PostalCode: 23113
CountryCode: US
TelephoneNumber: 8047949789
FaxNumber: 8047949762
Practice Location
Address1: 14001 CHARTER PARK DRIVE
Address2:  
City: MIDLOTHIAN
State: VA
PostalCode: 23114
CountryCode: US
TelephoneNumber: 8047391011
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/16/2007
LastUpdateDate: 08/04/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/04/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
122300000X0401410213VAY Dental ProvidersDentist 

No ID Information.


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