Individual provider Active NPI

Nicholas John Dirienzo, DMD

  • Dentist
  • Arlington, VA
National Provider Identifier
1013604255
Registry record updated Nov 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401419155 Issued in VA
Practice address
1050 N Highland St Ste 300N
Arlington, VA 22201-2197
Phone
(703) 527-3888
NPI assigned
Apr 19, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401419155 VA Primary

Addresses

Primary practice location

1050 N Highland St Ste 300N
Arlington, VA 22201-2197

Mailing address

419 Mockingbird Way
Hockessin, DE 19707-2051

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20230809002738 NC Order and Referring Only - DentistPractitioner - Dentist 4587026406

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0401419155VAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1681862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763078400000",
    "number": "1013604255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 MOCKINGBIRD WAY",
            "city": "HOCKESSIN",
            "state": "DE",
            "postal_code": "197072051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 N HIGHLAND ST STE 300N",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222012197",
            "telephone_number": "703-527-3888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIRIENZO",
        "first_name": "NICHOLAS",
        "middle_name": "JOHN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-19",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401419155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, VA

Sources for this page

Verify at the official NPI Registry.