NPIMap

Organization Active NPI

Saman Madani DMD & Shadi Shareghi DDS PC

  • Dentist
  • Fairfax, VA
National Provider Identifier
1073887741
Registry record updated Feb 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401410760 Issued in VA
Legal business name
SAMAN MADANI DMD & SHADI SHAREGHI DDS PC
Doing business as
Sunny Smiles Pediatric and Family Dentistry
Practice address
3930 Pender Dr
Suite #250
Fairfax, VA 22030-0985
Phone
(703) 865-5779
Fax
(703) 865-5543
NPI assigned
Feb 28, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2012

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

Authorized official

Name
Dr. Saman Madani, D.M.D.
Title
Dentist/Owner
Phone
(703) 865-5779

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 0401410760 VA Primary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 0401412634 VA

Addresses

Primary practice location

3930 Pender Dr
Suite #250
Fairfax, VA 22030-0985

Mailing address

3930 Pender Dr
Suite #250
Fairfax, VA 22030-0985
Phone (703) 865-5779

Other identifiers 1

IdentifierTypeStateIssuer
CX014MedicaidVA

Other names 1

  • Sunny Smiles Pediatric and Family Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

3930 Pender Dr
Ste 250
Fairfax, VA 22030
Phone (703) 865-5779

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1330387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330387200000",
    "number": "1073887741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3930 PENDER DR",
            "address_2": "SUITE #250",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220300985",
            "telephone_number": "703-865-5779",
            "fax_number": "703-865-5543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3930 PENDER DR",
            "address_2": "SUITE #250",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220300985",
            "telephone_number": "703-865-5779",
            "fax_number": "703-865-5543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMAN MADANI DMD & SHADI SHAREGHI DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-28",
        "last_updated": "2012-02-28",
        "status": "A",
        "authorized_official_last_name": "MADANI",
        "authorized_official_first_name": "SAMAN",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "703-865-5779",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401410760",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "VA",
            "license": "0401412634",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CX014",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunny Smiles Pediatric and Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 28, 2012; 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.