Individual provider Active NPI

Jacob Mirpanah, DDS

  • General Practice Dentistry
  • Virginia Beach, VA
National Provider Identifier
1013653518
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401417927 Issued in VA
Practice address
984 First Colonial Rd Ste 200
Virginia Beach, VA 23454-3196
Phone
(757) 412-2235
NPI assigned
May 7, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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 0401417927 VA Primary

Addresses

Primary practice location

984 First Colonial Rd Ste 200
Virginia Beach, VA 23454-3196

Mailing address

44040 Bruceton Mills Cir
Ashburn, VA 20147-4808
Phone (703) 650-8265

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
0401417927VAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Mirpanah & Fazel Dental Current Accepting new patients
Oakes Dental LLC General Practice CurrentSince Jun 26, 2022 Accepting new patients
Marybeth Fasano DMD PC Past Accepting new patients

Locations

984 First Colonial Rd
Ste 200
Virginia Beach, VA 23454
Phone (757) 412-2235

Networks

  • IA HMO C-SNP
  • devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d

Organizations & group practices 3

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": "1651881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1013653518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44040 BRUCETON MILLS CIR",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201474808",
            "telephone_number": "703-650-8265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "984 FIRST COLONIAL RD STE 200",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234543196",
            "telephone_number": "757-412-2235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRPANAH",
        "first_name": "JACOB",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-07",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401417927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2026; 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.