Family Orthodontics of Virginia LLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

0401414164 Issued in VA

Legal business name

FAMILY ORTHODONTICS OF VIRGINIA LLC

Practice address

6225 Brandon Ave Ste 170
Springfield, VA 22150-2525

Phone

(404) 389-1950

Fax

(678) 444-4152

NPI assigned

Oct 8, 2014

Organization subpart

No

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

Authorized official

Name

Jeannine Bartch

Title

Credentialing Manager

Phone

(404) 389-1950

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marie Coffelt, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Springfield, VA
  • NPI 1538566567
  NPD (past)

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

{
    "created_epoch": "1412726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412726400000",
    "number": "1053714766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 SPRING ST NW STE 600",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303092870",
            "telephone_number": "404-389-1950",
            "fax_number": "678-444-4152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6225 BRANDON AVE STE 170",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221502525",
            "telephone_number": "404-389-1950",
            "fax_number": "678-444-4152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY ORTHODONTICS OF VIRGINIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-08",
        "last_updated": "2014-10-08",
        "status": "A",
        "authorized_official_last_name": "BARTCH",
        "authorized_official_first_name": "JEANNINE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "404-389-1950"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "VA",
            "license": "0401414164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Dental, PC
• Family Health Care Center
• Alyssa Marie Fanizzi
• Reza Fardshisheh, DMD
• Hanna Farid
• Azra A Farooqui, MD
• Fassity Home Care LLC

• Orthodontics and Dentofacial Orthopedics Dentistry in Springfield, VA
• Providers in Springfield, VA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2014; 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.