Jennifer Hilario Diaz, DMD, MS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

0401411082 Issued in VA

Practice address

8230 Boone Blvd Ste 410
Vienna, VA 22182-2646

Phone

(703) 848-8906

NPI assigned

Nov 2, 2006

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective May 17, 2019 through May 17, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• RBH Dental MGT. Group, Inc

  • Periodontics
  • Burke, VA
  • NPI 1598983314
  NPD (past) Authorized official
• Alexander Osinovsky, DDS PC

  dba Tysons Dental Associates

  • General Practice Dentistry
  • Vienna, VA
  • NPI 1609953728
  NPD (past)

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1154409506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9612 MINSTEAD CT",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "220154056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8230 BOONE BLVD STE 410",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822646",
            "telephone_number": "703-848-8906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "JENNIFER",
        "middle_name": "HILARIO",
        "name_prefix": "Dr.",
        "credential": "DMD, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "VA",
            "license": "0401411082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph J Devylder, DDS
• Robert H Dewitt, D.D.S.
• Virender Dhawer, MD
• Diane Hofstadter, LLC
• Nadda Diasti, MA, CCC-SLP, IBCLC
• Dina Edelbi DMD PLLC
• Vostina Dinovo, PHD
• Brenda Dintiman, M.D.
• Cristina Carmen Dinunzio, PT
• Distinctive Dermatology PLLC

• Periodontics in Vienna, VA
• Providers in Vienna, VA by specialty
• Periodontics in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.