Individual provider Active NPI

Steve Juh Lan, D.D.S.

  • Pediatric Dentistry
  • Leesburg, VA
National Provider Identifier
1033369574
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
0401412388 Issued in VA
Practice address
1503 Dodona Ter Ste 200
Leesburg, VA 20175-4718
Phone
(703) 771-0007
Fax
(703) 771-6088
NPI assigned
Sep 20, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 0401412388 VA Primary

Addresses

Primary practice location

1503 Dodona Ter Ste 200
Leesburg, VA 20175-4718

Mailing address

22425 Belle Terra Dr
Ashburn, VA 20148-7160
Phone (703) 771-0007

Other practice location 1

43490 Yukon Dr Ste 105
Ashburn, VA 20147-7303
Phone (703) 665-4955

Other identifiers 1

IdentifierTypeStateIssuer
035518600MedicaidVA

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
0401412388VAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Steve J Lan DDS PC Pediatric Dentistry CurrentSince Aug 9, 2020 Accepting new patients
S. J. Lan DDS PLLC Pediatric Dentistry CurrentSince Jul 27, 2020 Accepting new patients
Steve J Lan DDS PC Pediatric Dentistry CurrentSince Aug 9, 2020 Accepting new patients

Locations

43490 Yukon Dr
Ste 105
Ashburn, VA 20147
Phone (703) 665-4955

540 Fort Evans Rd
Ste 110
Leesburg, VA 20176
Phone (703) 777-6550

1503 Dodona Ter
Ste 200
Leesburg, VA 20175
Phone (703) 771-0007

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": "1221868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1033369574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22425 BELLE TERRA DR",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201487160",
            "telephone_number": "703-771-0007",
            "fax_number": "703-771-6088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1503 DODONA TER STE 200",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201754718",
            "telephone_number": "703-771-0007",
            "fax_number": "703-771-6088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "43490 Yukon Dr Ste 105",
            "address_purpose": "LOCATION",
            "city": "Ashburn",
            "state": "VA",
            "postal_code": "201477303",
            "country_code": "US",
            "telephone_number": "703-665-4955",
            "fax_number": "703-665-4551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAN",
        "first_name": "STEVE",
        "middle_name": "JUH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-20",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "VA",
            "license": "0401412388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "035518600",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2020; 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.