Active NPI
Farnaz Younessian
- Orthodontics and Dentofacial Orthopedics Dentistry
- Fairfax, VA
National Provider Identifier
1053993295
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 0401416814
- Practice address
- 3903 Fair Ridge Dr Ste 215
Fairfax, VA 22033-2945 - Phone
- (571) 559-1343
- NPI assigned
- Apr 27, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 0401416814 | VA | Primary |
Addresses
Primary practice location
3903 Fair Ridge Dr Ste 215
Fairfax, VA 22033-2945
Mailing address
10610 Canfield St
Fairfax, VA 22030-8155
Phone (949) 527-8434
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 |
|---|---|---|---|
| 0401416814 | VA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1619481600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619481600000",
"number": "1053993295",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10610 CANFIELD ST",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220308155",
"telephone_number": "949-527-8434"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3903 FAIR RIDGE DR STE 215",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220332945",
"telephone_number": "571-559-1343"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNESSIAN",
"first_name": "FARNAZ",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-04-27",
"last_updated": "2021-04-27",
"certification_date": "2021-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "VA",
"license": "0401416814",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.