Individual provider Active NPI

Mana A Badipour, DDS

  • General Practice Dentistry
  • Vienna, VA
National Provider Identifier
1063567824
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401410392 Issued in VA
Practice address
8618 Westwood Center Dr
Suite 109
Vienna, VA 22182-2222
Phone
(703) 848-1999
NPI assigned
Jan 24, 2007
Sex
Female
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 0401410392 VA Primary

Addresses

Primary practice location

8618 Westwood Center Dr
Suite 109
Vienna, VA 22182-2222

Mailing address

8618 Westwood Center Dr
Suite 109
Vienna, VA 22182-2222
Phone (703) 848-1999

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
0401410392VAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063567824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8618 WESTWOOD CENTER DR",
            "address_2": "SUITE 109",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822222",
            "telephone_number": "703-848-1999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8618 WESTWOOD CENTER DR",
            "address_2": "SUITE 109",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822222",
            "telephone_number": "703-848-1999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADIPOUR",
        "first_name": "MANA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401410392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vienna, 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.