NPIMap

Organization Active NPI

Pearly Whites Family Dental

  • General Practice Dentistry
  • Springfield, VA
National Provider Identifier
1114357498
Registry record updated Dec 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
04014713726 Issued in VA
Legal business name
PEARLY WHITES FAMILY DENTAL
Practice address
7227 Commerce St
Springfield, VA 22150-3411
Phone
(703) 992-7778
Fax
(571) 565-2204
NPI assigned
Nov 22, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2016

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

Authorized official

Name
Agustina N Mustafa
Title
Office Manager
Phone
(703) 992-7778

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 04014713726 VA Primary

Addresses

Primary practice location

7227 Commerce St
Springfield, VA 22150-3411

Mailing address

7227 Commerce St
Springfield, VA 22150-3411
Phone (703) 992-7778

National Provider Directory

National Provider Directory

Locations

7227 Commerce St
Springfield, VA 22150
Phone (703) 992-7778

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": "1385078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482883200000",
    "number": "1114357498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7227 COMMERCE ST",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221503411",
            "telephone_number": "703-992-7778",
            "fax_number": "571-565-2204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7227 COMMERCE ST",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221503411",
            "telephone_number": "703-992-7778",
            "fax_number": "571-565-2204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEARLY WHITES FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-22",
        "last_updated": "2016-12-28",
        "status": "A",
        "authorized_official_last_name": "MUSTAFA",
        "authorized_official_first_name": "AGUSTINA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "703-992-7778"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "04014713726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2016; 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.