NPIMap

Organization Active NPI

Fairfaxdentalgroup

  • General Practice Dentistry
  • Fairfax, VA
National Provider Identifier
1073986568
Registry record updated Nov 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
FAIRFAXDENTALGROUP
Practice address
8316 Arlington Blvd
Fairfax, VA 22031-5207
Phone
(703) 560-6301
Fax
(703) 560-1334
NPI assigned
Nov 5, 2015
Last updated
Nov 5, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
POTOMAC VALLEY DENTAL CARE PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 5, 2015

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

Authorized official

Name
Dr. Michael Gorman, DDSNPI 1841206042
Title
Dentist/Owner
Phone
(703) 830-9110

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

8316 Arlington Blvd
Fairfax, VA 22031-5207

Mailing address

8316 Arlington Blvd
Fairfax, VA 22031-5207
Phone (703) 560-6301

National Provider Directory

National Provider Directory
Tax ID family
Brenda J Young DDS Marjun Ayati DDS PC2 organizations share this tax ID, including this one
Part of
Potomac Valley Dental Care PLLC

Other organizations with this tax ID 1

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1446681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446681600000",
    "number": "1073986568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8316 ARLINGTON BLVD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220315207",
            "telephone_number": "703-560-6301",
            "fax_number": "703-560-1334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8316 ARLINGTON BLVD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220315207",
            "telephone_number": "703-560-6301",
            "fax_number": "703-560-1334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRFAXDENTALGROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "POTOMAC VALLEY DENTAL CARE PLLC",
        "enumeration_date": "2015-11-05",
        "last_updated": "2015-11-05",
        "status": "A",
        "authorized_official_last_name": "GORMAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "703-830-9110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "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 Nov 5, 2015; 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.