Jair P Urteaga, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401412624 Issued in VA

Practice address

10068 Dumfries Rd
Manassas, VA 20110-7949

Phone

(703) 330-0430

NPI assigned

Oct 27, 2009

Last updated

Oct 27, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1256601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256601600000",
    "number": "1245566132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5225 POMMEROY DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220323921",
            "telephone_number": "703-623-5702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10068 DUMFRIES RD",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201107949",
            "telephone_number": "703-330-0430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URTEAGA",
        "first_name": "JAIR",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-10-27",
        "last_updated": "2009-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401412624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Manassas, VA
• Providers in Manassas, 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 Oct 27, 2009; 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.