Provider Demographics
NPI:1215048046
Name:VORCHEIMER, ROGER F (DDS)
Entity type:Individual
Prefix:
First Name:ROGER
Middle Name:F
Last Name:VORCHEIMER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6405 SHIPLETT BLVD
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-3446
Mailing Address - Country:US
Mailing Address - Phone:703-455-5466
Mailing Address - Fax:703-455-2134
Practice Address - Street 1:6405 SHIPLETT BLVD
Practice Address - Street 2:
Practice Address - City:BURKE
Practice Address - State:VA
Practice Address - Zip Code:22015-3446
Practice Address - Country:US
Practice Address - Phone:703-455-5466
Practice Address - Fax:703-455-2134
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA4362122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist