Individual provider Active NPI

Jailan Abdelrazek, D .D.S

  • General Practice Dentistry
  • Potomac Falls, VA
National Provider Identifier
1174681738
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401410144 Issued in VA
Practice address
46165 Westlake Dr Ste 110
Potomac Falls, VA 20165-5872
Phone
(703) 444-6150
Fax
(703) 444-6151
NPI assigned
Dec 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0401410144 VA Primary

Addresses

Primary practice location

46165 Westlake Dr Ste 110
Potomac Falls, VA 20165-5872

Mailing address

46165 Westlake Dr Ste 110
Potomac Falls, VA 20165-5872
Phone (703) 444-6150

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

LicenseStateTypeSpecialty
0401410144VAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174681738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46165 WESTLAKE DR STE 110",
            "city": "POTOMAC FALLS",
            "state": "VA",
            "postal_code": "201655872",
            "telephone_number": "703-444-6150",
            "fax_number": "703-444-6151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46165 WESTLAKE DR STE 110",
            "city": "POTOMAC FALLS",
            "state": "VA",
            "postal_code": "201655872",
            "telephone_number": "703-444-6150",
            "fax_number": "703-444-6151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDELRAZEK",
        "first_name": "JAILAN",
        "name_prefix": "Dr.",
        "credential": "D .D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401410144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Potomac Falls, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.