GD VA Fairlington, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

GD VA FAIRLINGTON, PLLC

Doing business as

Fairlington Dental

Practice address

4850 31St St S Ste a
Arlington, VA 22206-1661

Phone

(703) 671-1001

NPI assigned

Nov 18, 2022

Last updated

Nov 18, 2022By the provider in NPPES

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

• Fairlington Dental Doing business as

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

{
    "created_epoch": "1668729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668729600000",
    "number": "1215646161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 31ST ST S STE A",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222061661",
            "telephone_number": "703-671-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 31ST ST S STE A",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222061661",
            "telephone_number": "703-671-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GD VA FAIRLINGTON, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-18",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-18",
        "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": "Fairlington Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Caroline Gates, MSN, RN, CDCES
• Jason Lamar Gates, PMHNP-BC, MSN
• Jacques Tomoonh Gbaba, LGSW
• GD VA Ade PLLC (Arlington Dental Excellence)
• GD VA Arlington PLLC (Arlington Dental Aesthetics)
• Hirut A Gebre, NP
• Aaron Gebrelul, MD
• Elizabeth Sebsibe Gebremariam, MD
• Semhar Gebrenegus
• Kedest Gebreselassie, FNP

• General Practice Dentistry in Arlington, VA
• Providers in Arlington, 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 Nov 18, 2022; 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.