Active NPI
Mita Dulabh, D.M.D
- Dentist
- Woodbridge, VA
National Provider Identifier
1164620142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 0401412184
- Practice address
- 2970 Prince William Pkwy
Woodbridge, VA 22192-4145 - Phone
- (703) 583-7720
- NPI assigned
- Jul 11, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 0401412184 | VA | Primary |
Addresses
Primary practice location
2970 Prince William Pkwy
Woodbridge, VA 22192-4145
Mailing address
5587 Callcott Way
Apt 1102
Alexandria, VA 22312-4009
Phone (859) 576-5459
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401412184 | VA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1242777600000",
"number": "1164620142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5587 CALLCOTT WAY",
"address_2": "APT 1102",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223124009",
"telephone_number": "859-576-5459"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2970 PRINCE WILLIAM PKWY",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221924145",
"telephone_number": "703-583-7720"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DULABH",
"first_name": "MITA",
"credential": "D.M.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-11",
"last_updated": "2009-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VA",
"license": "0401412184",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodbridge, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.