Active NPI
Elda A Bordon, DDS, MPH
- Dentist
- Reston, VA
National Provider Identifier
1194098624
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 0401413400
- Practice address
- 1800 Michael Faraday Dr
Suite 205
Reston, VA 20190-5354 - Phone
- (571) 926-8429
- Fax
- (571) 926-8429
- NPI assigned
- Feb 14, 2012
- Last updated
- May 1, 2012
- 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 | 0401413400 | VA | Primary |
Addresses
Primary practice location
1800 Michael Faraday Dr
Suite 205
Reston, VA 20190-5354
Mailing address
3811 E West Hwy
Chevy Chase, MD 20815-5918
Phone (301) 654-1266
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 |
|---|---|---|---|
| 0401413400 | VA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1335830400000",
"number": "1194098624",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3811 E WEST HWY",
"city": "CHEVY CHASE",
"state": "MD",
"postal_code": "208155918",
"telephone_number": "301-654-1266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 MICHAEL FARADAY DR",
"address_2": "SUITE 205",
"city": "RESTON",
"state": "VA",
"postal_code": "201905354",
"telephone_number": "571-926-8429",
"fax_number": "571-926-8429"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORDON",
"first_name": "ELDA",
"middle_name": "A",
"credential": "DDS, MPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-02-14",
"last_updated": "2012-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VA",
"license": "0401413400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reston, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.