Individual provider Active NPI

Raman K Jassal, D.D.S.

  • General Practice Dentistry
  • Herndon, VA
National Provider Identifier
1063435048
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401006711 Issued in VA
Practice address
112 Elden St
Suite #N
Herndon, VA 20170-4874
Phone
(703) 787-9000
Fax
(703) 787-9000
NPI assigned
Jul 25, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0401006711 VA Primary

Addresses

Primary practice location

112 Elden St
Suite #N
Herndon, VA 20170-4874

Mailing address

112 Elden St
Suite #N
Herndon, VA 20170-4874
Phone (703) 787-9000

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
0401006711VAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Lina Jameel DDS PLLC General Practice PastSince Feb 6, 2022 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8239/brand/1/csg/1/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063435048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 ELDEN ST",
            "address_2": "SUITE #N",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704874",
            "telephone_number": "703-787-9000",
            "fax_number": "703-787-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 ELDEN ST",
            "address_2": "SUITE #N",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704874",
            "telephone_number": "703-787-9000",
            "fax_number": "703-787-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JASSAL",
        "first_name": "RAMAN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401006711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Herndon, 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.

Verify at the official NPI Registry.