Vincy M Punnoose, BDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401415919 Issued in VA

Practice address

10432 Balls Ford Rd, Suite 300
Manassas, VA 20109

Phone

(888) 833-8441

NPI assigned

Mar 28, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1332892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575244800000",
    "number": "1154697720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BIG SMILES VIRGINIA PC",
            "address_2": "10432 BALLS FORD RD,SUITE 300",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "20109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10432 BALLS FORD RD, SUITE 300",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "20109",
            "telephone_number": "888-833-8441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUNNOOSE",
        "first_name": "VINCY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "BDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-28",
        "last_updated": "2019-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DENT.DE.60212131",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401415919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Manassas, VA
• Providers in Manassas, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2019; 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.