Individual provider Active NPI

Bruce T Sallen, DMD

  • Endodontics
  • Falls Church, VA
National Provider Identifier
1114000817
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
0401008189 Issued in VA
Practice address
311 Park Ave
Falls Church, VA 22046
Phone
(703) 534-4884
Fax
(703) 534-3447
NPI assigned
Oct 24, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 0401008189 VA Primary

Addresses

Primary practice location

311 Park Ave
Falls Church, VA 22046

Mailing address

311 Park Ave
Falls Church, VA 22046
Phone (703) 534-4884

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
0401008189VAMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Stanley M Levin, DDS. Gary Sleff DDS & Richard M. Pollock, DMD, LTD 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114000817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 PARK AVE",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "22046",
            "telephone_number": "703-534-4884",
            "fax_number": "703-534-3447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 PARK AVE",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "22046",
            "telephone_number": "703-534-4884",
            "fax_number": "703-534-3447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALLEN",
        "first_name": "BRUCE",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "VA",
            "license": "0401008189",
            "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 Jul 8, 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.