Active NPI
David Eugene Dodrill, DDS
- Dentist
- Reston, VA
National Provider Identifier
1043380272
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 0401003604
- Practice address
- 11503 Sunrise Valley Drive
Reston, VA 20190 - Phone
- (703) 860-3200
- Fax
- (703) 391-8828
- NPI assigned
- Nov 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 0401003604 | VA | Primary |
Addresses
Primary practice location
11503 Sunrise Valley Drive
Reston, VA 20190
Mailing address
43442 Firestone Place
Leesburg, VA 20176
Phone (703) 669-4550
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0401003604 | VA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reston Dental Group, PC | 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.
-
- Dental Clinic/Center
- Reston, VA
- NPI 1427128669
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043380272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "43442 FIRESTONE PLACE",
"city": "LEESBURG",
"state": "VA",
"postal_code": "20176",
"telephone_number": "703-669-4550",
"fax_number": "703-669-4556"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11503 SUNRISE VALLEY DRIVE",
"city": "RESTON",
"state": "VA",
"postal_code": "20190",
"telephone_number": "703-860-3200",
"fax_number": "703-391-8828"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DODRILL",
"first_name": "DAVID",
"middle_name": "EUGENE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VA",
"license": "0401003604",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reston, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.