Individual provider Active NPI

Edward A Reeves, DDS

  • General Practice Dentistry
  • Lorton, VA
National Provider Identifier
1033250931
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401004477 Issued in VA
Practice address
7764 Armistead Rd
Suite 100
Lorton, VA 22079-1919
Phone
(703) 339-5090
Fax
(703) 339-1068
NPI assigned
Feb 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 0401004477 VA Primary

Addresses

Primary practice location

7764 Armistead Rd
Suite 100
Lorton, VA 22079-1919

Mailing address

20269 Water Mark PL
Potomac Falls, VA 20165-5134
Phone (703) 450-0675

Other identifiers 1

IdentifierTypeStateIssuer
781417OtherVAUNITED CONCORIDA PROVIDER

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
I20150505001049 VA Order and Referring Only - DentistPractitioner - Dentist 3072832542

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Aesthetic Dentistry of Lorton General Practice Past 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": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033250931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20269 WATER MARK PL",
            "city": "POTOMAC FALLS",
            "state": "VA",
            "postal_code": "201655134",
            "telephone_number": "703-450-0675",
            "fax_number": "703-339-1068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7764 ARMISTEAD RD",
            "address_2": "SUITE 100",
            "city": "LORTON",
            "state": "VA",
            "postal_code": "220791919",
            "telephone_number": "703-339-5090",
            "fax_number": "703-339-1068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REEVES",
        "first_name": "EDWARD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401004477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORIDA PROVIDER",
            "identifier": "781417",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lorton, VA

Sources for this page

Verify at the official NPI Registry.