Leesburg Dental Group PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

LEESBURG DENTAL GROUP PLLC

Practice address

19 Catoctin Cir NE
Leesburg, VA 20176-3100

Phone

(703) 737-0070

NPI assigned

Mar 15, 2023

Organization subpart

No

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

Authorized official

Name

Geith Kallas, DDS

Title

Owner

Phone

(703) 622-3300

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1678838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692748800000",
    "number": "1063113199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8310 OLD COURTHOUSE RD STE A",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 CATOCTIN CIR NE",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201763100",
            "telephone_number": "703-737-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEESBURG DENTAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-15",
        "last_updated": "2023-08-23",
        "certification_date": "2023-07-17",
        "status": "A",
        "authorized_official_last_name": "KALLAS",
        "authorized_official_first_name": "GEITH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-622-3300",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Leesburg, VA
• Providers in Leesburg, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; 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.