Active NPI
Trang Salzberg, DDS
- Periodontics
- Vienna, VA
National Provider Identifier
1073536306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 04014110596
- Practice address
- 243 Church St NW Ste 200a
Vienna, VA 22180-4434 - Phone
- (703) 938-6022
- Fax
- (703) 938-6039
- NPI assigned
- Jul 26, 2006
- 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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 04014110596 | VA | Primary |
Addresses
Primary practice location
243 Church St NW Ste 200a
Vienna, VA 22180-4434
Mailing address
243 Church St NW Ste 200a
Vienna, VA 22180-4434
Phone (703) 938-6022
Other practice location 1
477 Viking Dr
suite 190
Virginia Beach, VA 23452-7349
Phone (757) 486-8181
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Feb 26, 2024 through Feb 26, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04014110596 | VA | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Konikoff Periodontics LTD | Periodontics | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Periodontics
- Virginia Beach, VA
- NPI 1477706737
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716508800000",
"number": "1073536306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "243 CHURCH ST NW STE 200A",
"city": "VIENNA",
"state": "VA",
"postal_code": "221804434",
"telephone_number": "703-938-6022",
"fax_number": "703-938-6039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "243 CHURCH ST NW STE 200A",
"city": "VIENNA",
"state": "VA",
"postal_code": "221804434",
"telephone_number": "703-938-6022",
"fax_number": "703-938-6039"
}
],
"practiceLocations": [
{
"address_1": "477 Viking Dr",
"address_2": "suite 190",
"address_purpose": "LOCATION",
"city": "Virginia Beach",
"state": "VA",
"postal_code": "234527349",
"country_code": "US",
"telephone_number": "757-486-8181",
"fax_number": "757-463-0148",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SALZBERG",
"first_name": "TRANG",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-26",
"last_updated": "2024-05-24",
"certification_date": "2024-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "VA",
"license": "04014110596",
"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 May 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.