Provider Demographics
NPI:1730064296
Name:STEPHEN BEECROFT SPECIALTY PARTNERS OF VIRGINIA PLLC
Entity type:Organization
Organization Name:STEPHEN BEECROFT SPECIALTY PARTNERS OF VIRGINIA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:KRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-934-7995
Mailing Address - Street 1:820 W 42ND ST STE 2300
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-5016
Mailing Address - Country:US
Mailing Address - Phone:308-260-0241
Mailing Address - Fax:
Practice Address - Street 1:11113 LEAVELLS RD
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-5015
Practice Address - Country:US
Practice Address - Phone:540-898-2200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-06
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty