Individual provider Active NPI

Craig Ernest Vigliante, MD DMD

  • Plastic Surgery Physician
  • Leesburg, VA
National Provider Identifier
1164591970
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
0401410769 Issued in VA
Practice address
19440 Golf Vista Plaza
Ste 130
Leesburg, VA 20176
Phone
(703) 723-5366
Fax
(703) 723-5537
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 0401410769 VA
Plastic Surgery Physician 208200000X 0401410769 VA Primary

Addresses

Primary practice location

19440 Golf Vista Plaza
Ste 130
Leesburg, VA 20176

Mailing address

19440 Golf Vista Plaza
Ste 130
Leesburg, VA 20176
Phone (703) 723-5366

Medicare participation

Medicare enrollment files
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 Jul 8, 2013 through Jul 8, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0401410769VAMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Reston Oral and Facial Surgery PLLC CurrentSince Jun 2, 2024 Accepting new patients
Niamtu & Alexander Oral & Maxillofacial Surgery PC Oral & Maxillofacial Surgery Past Accepting new patients
Potomac Surgical Arts,PC PastSince Jul 8, 2011 Accepting new patients

Locations

1890 Preston White Dr
Ste 100
Reston, VA 20191
Phone (571) 595-3223

Organizations & group practices 3

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": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1164591970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19440 GOLF VISTA PLAZA",
            "address_2": "STE 130",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "20176",
            "telephone_number": "703-723-5366",
            "fax_number": "703-723-5537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19440 GOLF VISTA PLAZA",
            "address_2": "STE 130",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "20176",
            "telephone_number": "703-723-5366",
            "fax_number": "703-723-5537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIGLIANTE",
        "first_name": "CRAIG",
        "middle_name": "ERNEST",
        "name_prefix": "Dr.",
        "credential": "MD DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "VA",
            "license": "0401410769",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "VA",
            "license": "0401410769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

Verify at the official NPI Registry.