NPIMap

Organization Active NPI

Potomac Valley Dental Care PLLC

  • Dentist
  • Centreville, VA
National Provider Identifier
1013387737
Registry record updated Oct 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
POTOMAC VALLEY DENTAL CARE PLLC
Practice address
14245P Centreville SQ
Centreville, VA 20121-2368
Phone
(703) 830-9110
Fax
(703) 830-1632
NPI assigned
Oct 7, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2015

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

Authorized official

Name
Dr. Michael Harkins Gorman, DDS
Title
Dentist
Phone
(703) 830-9110

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

14245P Centreville SQ
Centreville, VA 20121-2368

Mailing address

14245P Centreville SQ
Centreville, VA 20121-2368
Phone (703) 830-9110

National Provider Directory

National Provider Directory
Tax ID family
Giovanni P Iuculano DDS PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Subparts reporting this organization as parent 26

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1444176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444176000000",
    "number": "1013387737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14245P CENTREVILLE SQ",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201212368",
            "telephone_number": "703-830-9110",
            "fax_number": "703-830-1632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14245P CENTREVILLE SQ",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201212368",
            "telephone_number": "703-830-9110",
            "fax_number": "703-830-1632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTOMAC VALLEY DENTAL CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-07",
        "last_updated": "2015-10-07",
        "status": "A",
        "authorized_official_last_name": "GORMAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "HARKINS",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "703-830-9110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centreville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2015; 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.