Individual provider Active NPI

Gianandrea Ribeiro Wotfe, DMD

  • General Practice Dentistry
  • Falls Church, VA
National Provider Identifier
1003597436
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401418358 Issued in VA
Practice address
105 N Virginia Ave
Falls Church, VA 22046-3339
Phone
(703) 533-7285
Fax
(703) 533-7287
NPI assigned
Jul 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0401418358 VA Primary

Addresses

Primary practice location

105 N Virginia Ave
Falls Church, VA 22046-3339

Mailing address

1115 Riva Ridge Dr
Great Falls, VA 22066-1616
Phone (425) 520-5237

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0401418358VAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1690416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1003597436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 RIVA RIDGE DR",
            "city": "GREAT FALLS",
            "state": "VA",
            "postal_code": "220661616",
            "telephone_number": "425-520-5237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 N VIRGINIA AVE",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220463339",
            "telephone_number": "703-533-7285",
            "fax_number": "703-533-7287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOTFE",
        "first_name": "GIANANDREA",
        "middle_name": "RIBEIRO",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-27",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401418358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Falls Church, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.