Individual provider Active NPI

Dean J Phass, DDS

  • General Practice Dentistry
  • Falls Church, VA
National Provider Identifier
1083807150
Registry record updated Aug 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Practice address
5205 Leesburg Pike
Suite 101
Falls Church, VA 22041-3802
Phone
(703) 824-0055
Fax
(703) 998-9859
NPI assigned
Aug 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2007

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

Specialties & licenses 1

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

Addresses

Primary practice location

5205 Leesburg Pike
Suite 101
Falls Church, VA 22041-3802

Mailing address

5205 Leesburg Pike
Suite 101
Falls Church, VA 22041-3802
Phone (703) 824-0055

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

LicenseStateTypeSpecialty
040106623VAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Jack C Phass Jr DDS Inc General Practice 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.

NPI Registry JSON

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

{
    "created_epoch": "1187740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187740800000",
    "number": "1083807150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5205 LEESBURG PIKE",
            "address_2": "SUITE 101",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220413802",
            "telephone_number": "703-824-0055",
            "fax_number": "703-998-9859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5205 LEESBURG PIKE",
            "address_2": "SUITE 101",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220413802",
            "telephone_number": "703-824-0055",
            "fax_number": "703-998-9859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHASS",
        "first_name": "DEAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-22",
        "last_updated": "2007-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Falls Church, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2007; 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.