Individual provider Active NPI

Ashley Diana Rosinski, D.D.S

  • Dentist
  • Manassas, VA
National Provider Identifier
1003102476
Registry record updated Jun 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401413180 Issued in VA
Practice address
10620 Crestwood Dr Ste a
Manassas, VA 20109-4403
Phone
(703) 361-2911
NPI assigned
Jun 23, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401413180 VA Primary

Addresses

Primary practice location

10620 Crestwood Dr Ste a
Manassas, VA 20109-4403

Mailing address

4589 Sudley Rd
Gainesville, VA 20155-1022
Phone (703) 853-8644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160711000425 VA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0547552606

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0401413180VAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Manassas Modern Dentistry PLLC Dentist PastSince Jul 24, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308787200000",
    "number": "1003102476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4589 SUDLEY RD",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201551022",
            "telephone_number": "703-853-8644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10620 CRESTWOOD DR STE A",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201094403",
            "telephone_number": "703-361-2911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSINSKI",
        "first_name": "ASHLEY",
        "middle_name": "DIANA",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-23",
        "last_updated": "2011-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401413180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

Verify at the official NPI Registry.