Active NPI
Mary A Speicher, DMD
- Dentist
- Gainesville, VA
National Provider Identifier
1205839073
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 0401007331
- Practice address
- 7915 Lake Manassas Dr
Suite 115
Gainesville, VA 20155-3258 - Phone
- (571) 261-9470
- Fax
- (571) 261-9472
- NPI assigned
- May 24, 2005
- Last updated
- Dec 2, 2021
- 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 | 0401007331 | VA | Primary |
Addresses
Primary practice location
7915 Lake Manassas Dr
Suite 115
Gainesville, VA 20155-3258
Mailing address
7519 Lake Manassas Drive
Suite 301
Gainesville, VA 20155
Phone (703) 743-5937
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 |
|---|---|---|---|
| 0401007331 | VA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1116892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638403200000",
"number": "1205839073",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7519 LAKE MANASSAS DRIVE",
"address_2": "SUITE 301",
"city": "GAINESVILLE",
"state": "VA",
"postal_code": "20155",
"telephone_number": "703-743-5937"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7915 LAKE MANASSAS DR",
"address_2": "SUITE 115",
"city": "GAINESVILLE",
"state": "VA",
"postal_code": "201553258",
"telephone_number": "571-261-9470",
"fax_number": "571-261-9472"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPEICHER",
"first_name": "MARY",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-05-24",
"last_updated": "2021-12-02",
"certification_date": "2021-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VA",
"license": "0401007331",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gainesville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.