Individual provider Active NPI

Lini Cai Mickus, D.M.D

  • General Practice Dentistry
  • Herndon, VA
National Provider Identifier
1033343645
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401418800 Issued in VA
Practice address
1141 Elden St
Herndon, VA 20170-5549
Phone
(703) 443-2000
NPI assigned
May 11, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0401418800 VA Primary
General Practice Dentistry 1223G0001X 000150 AL
Student in an Organized Health Care Education/Training Program 390200000X
Dentist 122300000X 9123 AZ

Addresses

Primary practice location

1141 Elden St
Herndon, VA 20170-5549

Mailing address

1141 Elden St
Herndon, VA 20170-5549
Phone (703) 443-2000

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
9123AZMDDentist
000150ALMDGeneral Practice Dentistry
0401418800VAMDGeneral Practice Dentistry

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ABDDAA/Endpoint/ABDDAA

NPI Registry JSON

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

{
    "created_epoch": "1242000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1033343645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 ELDEN ST",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201705549",
            "telephone_number": "703-443-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 ELDEN ST",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201705549",
            "telephone_number": "703-443-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKUS",
        "first_name": "LINI",
        "middle_name": "CAI",
        "name_prefix": "Miss",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-11",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401418800",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "000150",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "9123",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Herndon, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.