NPIMap

Organization Active NPI

Angel Heart & Soul Dentistry

  • General Practice Dentistry
  • Falls Church, VA
National Provider Identifier
1124414537
Registry record updated Apr 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401412284 Issued in VA
Legal business name
ANGEL HEART & SOUL DENTISTRY
Practice address
2942 Patrick Henry Dr
Falls Church, VA 22044-2904
Phone
(703) 533-8808
Fax
(703) 533-8420
NPI assigned
Apr 13, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2015

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

Authorized official

Name
Dr. Josemari De Leon Imao, DMD
Title
Owner/Dentist
Phone
(585) 354-1168

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 0401412284 VA Primary

Addresses

Primary practice location

2942 Patrick Henry Dr
Falls Church, VA 22044-2904

Mailing address

2942 Patrick Henry Dr
Falls Church, VA 22044-2904
Phone (703) 533-8808

National Provider Directory

National Provider Directory

Locations

2942 Patrick Henry Dr
Falls Church, VA 22044
Phone (703) 533-8808

NPI Registry JSON

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

{
    "created_epoch": "1428883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428883200000",
    "number": "1124414537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2942 PATRICK HENRY DR",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220442904",
            "telephone_number": "703-533-8808",
            "fax_number": "703-533-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2942 PATRICK HENRY DR",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220442904",
            "telephone_number": "703-533-8808",
            "fax_number": "703-533-8420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGEL HEART & SOUL DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-13",
        "last_updated": "2015-04-13",
        "status": "A",
        "authorized_official_last_name": "IMAO",
        "authorized_official_first_name": "JOSEMARI",
        "authorized_official_middle_name": "DE LEON",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "585-354-1168",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401412284",
            "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 Apr 13, 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.