NPIMap

Organization Active NPI

Alexandria Dental Center, PLLC

  • General Practice Dentistry
  • Alexandria, VA
National Provider Identifier
1093048654
Registry record updated Sep 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401410638 Issued in VA
Legal business name
ALEXANDRIA DENTAL CENTER, PLLC
Practice address
715 Pendleton St
Alexandria, VA 22314-1820
Phone
(571) 970-3783
Fax
(571) 970-3827
NPI assigned
Sep 15, 2009
Last updated
Sep 15, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2009

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

Authorized official

Name
Dr. Shiva Y Kermanshi, DMDNPI 1356474894
Title
Orthodontist
Phone
(703) 861-6797

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 0401410638 VA Primary

Addresses

Primary practice location

715 Pendleton St
Alexandria, VA 22314-1820

Mailing address

715 Pendleton St
Alexandria, VA 22314-1820
Phone (571) 970-3783

National Provider Directory

National Provider Directory

Locations

715 Pendleton St
Alexandria, VA 22314
Phone (571) 970-3783

Practitioners & affiliated clinicians

Practitioners 4

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": "1252972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252972800000",
    "number": "1093048654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 PENDLETON ST",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223141820",
            "telephone_number": "571-970-3783",
            "fax_number": "571-970-3827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 PENDLETON ST",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223141820",
            "telephone_number": "571-970-3783",
            "fax_number": "571-970-3827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEXANDRIA DENTAL CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-15",
        "last_updated": "2009-09-15",
        "status": "A",
        "authorized_official_last_name": "KERMANSHI",
        "authorized_official_first_name": "SHIVA",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "ORTHODONTIST",
        "authorized_official_telephone_number": "703-861-6797",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401410638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2009; 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.