Active NPI
Mohammad Hadi Kamalpour-Ansari, DMD
- Oral and Maxillofacial Surgery (Dentist)
- Alexandria, VA
National Provider Identifier
1235624818
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- 0401417780
- Practice address
- 2807 Duke St
Alexandria, VA 22314-4512 - Phone
- (412) 557-1294
- NPI assigned
- Jun 26, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 0401417780 | VA | Primary |
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 17356 | MD |
Addresses
Primary practice location
2807 Duke St
Alexandria, VA 22314-4512
Mailing address
5206 Lyngate CT
Burke, VA 22015
Phone (703) 425-5010
Other practice location 1
12317 Winchester Rd SW Ste 100
Lavale, MD 21502-6611
Phone (240) 803-3487
Other practice location 2
5206 lyngate court
Burke, VA 22015
Phone (703) 425-5010
Other practice location 3
11490 Commerce Park Dr Ste 100
Reston, VA 20191-1546
Phone (703) 736-1640
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 |
|---|---|---|---|
| 0401417780 | VA | MD | Oral and Maxillofacial Surgery (Dentist) |
| 17356 | MD | MD | Oral & Maxillofacial Surgery (D.M.D.) |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Akj Dental, DDS, LLC | Past | Accepting new patients | |
| Dr. Stuart L. Graves, DDS, Ms, PC | Oral and Maxillofacial Surgery | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Oral and Maxillofacial Surgery (Dentist)
- Burke, VA
- NPI 1124164108
-
- Dentist
- Lavale, MD
- NPI 1629423694
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711584000000",
"number": "1235624818",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5206 LYNGATE CT",
"city": "BURKE",
"state": "VA",
"postal_code": "22015",
"telephone_number": "703-425-5010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2807 DUKE ST",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223144512",
"telephone_number": "412-557-1294"
}
],
"practiceLocations": [
{
"address_1": "12317 Winchester Rd SW Ste 100",
"address_purpose": "LOCATION",
"city": "Lavale",
"state": "MD",
"postal_code": "215026611",
"country_code": "US",
"telephone_number": "240-803-3487",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5206 lyngate court",
"address_purpose": "LOCATION",
"city": "Burke",
"state": "VA",
"postal_code": "22015",
"country_code": "US",
"telephone_number": "703-425-5010",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "11490 Commerce Park Dr Ste 100",
"address_purpose": "LOCATION",
"city": "Reston",
"state": "VA",
"postal_code": "201911546",
"country_code": "US",
"telephone_number": "703-736-1640",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KAMALPOUR-ANSARI",
"first_name": "MOHAMMAD HADI",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-26",
"last_updated": "2024-03-28",
"certification_date": "2024-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "VA",
"license": "0401417780",
"primary": true
},
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "MD",
"license": "17356",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Alexandria, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.