Organization Active NPI

Modern Dental Smiles PLLC

  • General Practice Dentistry
  • Bealeton, VA
National Provider Identifier
1205788239
Registry record updated Feb 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MODERN DENTAL SMILES PLLC
Practice address
11077 Marsh Rd Ste a
Bealeton, VA 22712-5639
Phone
(571) 284-6424
Fax
(571) 636-1333
NPI assigned
Feb 11, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2026

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

Authorized official

Name
Malik Usman, DDSNPI 1225291800
Title
Dentist/Owner
Phone
(774) 208-4431

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

11077 Marsh Rd Ste a
Bealeton, VA 22712-5639

Mailing address

11077 Marsh Rd Ste a
Bealeton, VA 22712-5639
Phone (571) 284-6424

National Provider Directory

National Provider Directory

Locations

11077 Marsh Rd
#A
Bealeton, VA 22712
Phone (571) 284-6424

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": "1770768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770768000000",
    "number": "1205788239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11077 MARSH RD STE A",
            "city": "BEALETON",
            "state": "VA",
            "postal_code": "227125639",
            "telephone_number": "571-284-6424",
            "fax_number": "571-636-1333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11077 MARSH RD STE A",
            "city": "BEALETON",
            "state": "VA",
            "postal_code": "227125639",
            "telephone_number": "571-284-6424",
            "fax_number": "571-636-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN DENTAL SMILES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-11",
        "last_updated": "2026-02-11",
        "certification_date": "2026-02-11",
        "status": "A",
        "authorized_official_last_name": "USMAN",
        "authorized_official_first_name": "MALIK",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "774-208-4431",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bealeton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2026; 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.