GD VA Leesburg Pike PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

GD VA LEESBURG PIKE PLLC

Doing business as

Tysons Aesthetic Dentistry

Practice address

8150 Leesburg Pike Ste 503
Vienna, VA 22182-2714

Phone

(703) 532-2020

NPI assigned

Sep 3, 2024

Organization subpart

No

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

Authorized official

Name

Chad Hendricks

Title

Credentialing

Phone

(612) 859-0444

Specialties & licenses 1

Addresses

Other names 1

• Tysons Aesthetic Dentistry Doing business as

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

{
    "created_epoch": "1725321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725321600000",
    "number": "1184459828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8150 LEESBURG PIKE STE 503",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8150 LEESBURG PIKE STE 503",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822714",
            "telephone_number": "703-532-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GD VA LEESBURG PIKE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-03",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A",
        "authorized_official_last_name": "HENDRICKS",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "612-859-0444"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tysons Aesthetic Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hunter Garrett, PMHNP-BC
• Sanaa Gasmelsied, L.AC
• Gateway 4 ABA
• Leslie Hugh Gavora, M.D.
• Silvia Y Gazoni, FNP-C
• GD VA PLLC
• Meredith Lindsey Johnson Gelman, LCSW
• Gemmasohn Psychotherapy Service, LLC
• Jazmine Gendreau
• General and Cosmetic Dentistry

• General Practice Dentistry in Vienna, VA
• Providers in Vienna, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; 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.