Active NPI
Anisa Fanaeian, DMD
- Dentist
- Sterling, VA
National Provider Identifier
1073232625
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 0401418091
- Practice address
- 117 Coffee Tree CT
Sterling, VA 20164-2428 - Phone
- (404) 343-9462
- NPI assigned
- Aug 25, 2022
- Last updated
- Aug 25, 2022
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 0401418091 | VA | Primary |
Addresses
Primary practice location
117 Coffee Tree CT
Sterling, VA 20164-2428
Mailing address
117 Coffee Tree CT
Sterling, VA 20164-2428
Phone (404) 343-9462
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 |
|---|---|---|---|
| 0401418091 | VA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661385600000",
"number": "1073232625",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "117 COFFEE TREE CT",
"city": "STERLING",
"state": "VA",
"postal_code": "201642428",
"telephone_number": "404-343-9462"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "117 COFFEE TREE CT",
"city": "STERLING",
"state": "VA",
"postal_code": "201642428",
"telephone_number": "404-343-9462"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FANAEIAN",
"first_name": "ANISA",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-08-25",
"last_updated": "2022-08-25",
"certification_date": "2022-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VA",
"license": "0401418091",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sterling, VA
- Evercare (Visions Family Services)
- Evercare Hospice, Inc. (Evercare Hospice and Palliative Care)
- Darrian Faith
- Natalie M Falcone, LMT
- Family Allergy & Asthma Associates
- Badriya Farah
- Salma Faraz, DMD
- Farhad Zangeneh MD PC (Endocrine Diabetes & Osteroporosis Clinic)
- Mojgan Nassiri Farid, PHARM D
- Jill Farnsworth, LCSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.