Individual provider Active NPI

Pooja Gupta Kasperowski, DMD

  • General Practice Dentistry
  • Fairfax, VA
National Provider Identifier
1194913152
Registry record updated May 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401411921 Issued in VA
Practice address
11198 Lee Highway
Fairfax, VA 22030
Phone
(703) 591-5637
Fax
(703) 591-7934
NPI assigned
Oct 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401411921 VA
General Practice Dentistry 1223G0001X 0401411921 VA Primary

Addresses

Primary practice location

11198 Lee Highway
Fairfax, VA 22030

Mailing address

11198 Lee Highway
Fairfax, VA 22030
Phone (703) 591-5637

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0401411921VAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1191456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432771200000",
    "number": "1194913152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11198 LEE HIGHWAY",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "22030",
            "telephone_number": "703-591-5637",
            "fax_number": "703-591-7934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11198 LEE HIGHWAY",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "22030",
            "telephone_number": "703-591-5637",
            "fax_number": "703-591-7934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASPEROWSKI",
        "first_name": "POOJA",
        "middle_name": "GUPTA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-04",
        "last_updated": "2015-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401411921",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401411921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.