NPIMap

Organization Active NPI

Woodson Square Dental Care

  • General Practice Dentistry
  • Fairfax, VA
National Provider Identifier
1063754935
Registry record updated Mar 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
WOODSON SQUARE DENTAL CARE
Practice address
9671 Main St
Suite a
Fairfax, VA 22031-3742
Phone
(703) 323-0700
NPI assigned
Mar 19, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2013

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

Authorized official

Name
Nastaran Ejtemai
Title
Dentist/Owner
Phone
(703) 323-0700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

9671 Main St
Suite a
Fairfax, VA 22031-3742

Mailing address

9671 Main St
Suite a
Fairfax, VA 22031-3742
Phone (703) 323-0700

National Provider Directory

National Provider Directory
Tax ID family
Nastaran Ejtemai DDS PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

9671 Main St
Ste A
Fairfax, VA 22031
Phone (703) 323-0700

NPI Registry JSON

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

{
    "created_epoch": "1363651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363651200000",
    "number": "1063754935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9671 MAIN ST",
            "address_2": "SUITE A",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220313742",
            "telephone_number": "703-323-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9671 MAIN ST",
            "address_2": "SUITE A",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220313742",
            "telephone_number": "703-323-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODSON SQUARE DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-19",
        "last_updated": "2013-03-19",
        "status": "A",
        "authorized_official_last_name": "EJTEMAI",
        "authorized_official_first_name": "NASTARAN",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "703-323-0700"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "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 Mar 19, 2013; 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.