Organization Active NPI

Lets Smile Cosmetic Dentistry of Fairfax PLLC

  • General Practice Dentistry
  • Fairfax, VA
National Provider Identifier
1184348559
Registry record updated Sep 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
LETS SMILE COSMETIC DENTISTRY OF FAIRFAX PLLC
Practice address
4210 Fairfax Corner Ave W Ste 245
Fairfax, VA 22030-8627
Phone
(703) 719-5828
NPI assigned
Sep 29, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2022

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

Authorized official

Name
Dr. Ali Y Ghatri, DDS
Title
Member
Phone
(703) 719-5828

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

4210 Fairfax Corner Ave W Ste 245
Fairfax, VA 22030-8627

Mailing address

4210 Fairfax Corner Ave W Ste 245
Fairfax, VA 22030-8627
Phone (703) 719-5828

National Provider Directory

National Provider Directory

Locations

4210 Fairfax Corner Ave W
Ste 240
Fairfax, VA 22030
Phone (571) 234-5121

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1664409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664409600000",
    "number": "1184348559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4210 FAIRFAX CORNER AVE W STE 245",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220308627",
            "telephone_number": "703-719-5828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4210 FAIRFAX CORNER AVE W STE 245",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220308627",
            "telephone_number": "703-719-5828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LETS SMILE COSMETIC DENTISTRY OF FAIRFAX PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-29",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A",
        "authorized_official_last_name": "GHATRI",
        "authorized_official_first_name": "ALI",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "703-719-5828",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; 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.