Individual provider Active NPI

Sunil Pathak, DDS

  • General Practice Dentistry
  • Washington, DC
National Provider Identifier
1235811431
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DEN2000306 Issued in DC
Practice address
3925 Minnesota Ave NE
Washington, DC 20019-2662
Phone
(202) 396-1444
NPI assigned
Aug 7, 2023
Last updated
Sep 29, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 18169 MD
General Practice Dentistry 1223G0001X DEN2000306 DC Primary

Addresses

Primary practice location

3925 Minnesota Ave NE
Washington, DC 20019-2662

Mailing address

11917 Hayes Station Way
Manassas, VA 20109-4846
Phone (571) 591-5968

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

LicenseStateTypeSpecialty
DEN2000306DCMDGeneral Practice Dentistry
18169MDMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1691366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1235811431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11917 HAYES STATION WAY",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201094846",
            "telephone_number": "571-591-5968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3925 MINNESOTA AVE NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200192662",
            "telephone_number": "202-396-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATHAK",
        "first_name": "SUNIL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-07",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "18169",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "DC",
            "license": "DEN2000306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; 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.