Individual provider Active NPI

Peter Markov, DMD

  • Pediatric Dentistry
  • Arlington, VA
National Provider Identifier
1154841393
Registry record updated Aug 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
0401416354 Issued in VA
Practice address
5001 Lee Hwy
Arlington, VA 22207
Phone
(703) 962-7814
NPI assigned
Jun 20, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 0401416354 VA Primary

Addresses

Primary practice location

5001 Lee Hwy
Arlington, VA 22207

Mailing address

5001 Lee Hwy
Arlington, VA 22207-2541

Other practice location 1

4401 Penn Ave
Pittsburgh, PA 15224-1334
Phone (412) 647-6349

Other practice location 2

5001 Lee Hwy
Arlington, VA 22207
Phone (703) 962-7814

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170807001030 PA Order and Referring Only - DentistPractitioner - Dentist 7810268091

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0401416354VAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Kids Pediatric Dentistry PLLC Pediatric Dentistry Current 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564876800000",
    "number": "1154841393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 LEE HWY",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222072541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 LEE HWY",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "22207",
            "telephone_number": "703-962-7814"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4401 Penn Ave",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152241334",
            "country_code": "US",
            "telephone_number": "412-647-6349",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5001 Lee Hwy",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "VA",
            "postal_code": "22207",
            "country_code": "US",
            "telephone_number": "703-962-7814",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARKOV",
        "first_name": "PETER",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-20",
        "last_updated": "2019-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "VA",
            "license": "0401416354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, VA

Sources for this page

Verify at the official NPI Registry.