Provider Demographics
NPI:1215157748
Name:CADE, RONALD EVANS (DMD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:EVANS
Last Name:CADE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 COWARDIN AVE
Mailing Address - Street 2:206
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23224-2078
Mailing Address - Country:US
Mailing Address - Phone:804-233-2881
Mailing Address - Fax:804-233-2882
Practice Address - Street 1:101 COWARDIN AVE
Practice Address - Street 2:206
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23224-2078
Practice Address - Country:US
Practice Address - Phone:804-233-2881
Practice Address - Fax:804-233-2882
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010053991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
0000000049018OtherANTHEM BLUE CROSS