Dermatology Associates of Northern Virginia

Primary specialty

SpecialistTaxonomy code 174400000X

License

0101047432 Issued in VA

Legal business name

DERMATOLOGY ASSOCIATES OF NORTHERN VIRGINIA

Practice address

13880 Braddock Rd
301
Centreville, VA 20121-2459

Phone

(703) 222-2773

Fax

(703) 222-6093

NPI assigned

Jun 18, 2006

Organization subpart

No

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

Authorized official

Name

Neeraja Charagundla Mattay, M.D.

Title

Dr/Owner

Phone

(703) 222-2773

Specialties & licenses 1

Addresses

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Dermatology and Skin Cancer Specialists, LLC

  • Dermatology Physician
  • Leawood, KS
  • NPI 1205880846

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194912000000",
    "number": "1255376802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13880 BRADDOCK RD",
            "address_2": "301",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201212459",
            "telephone_number": "703-222-2773",
            "fax_number": "703-222-6093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13880 BRADDOCK RD",
            "address_2": "301",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201212459",
            "telephone_number": "703-222-2773",
            "fax_number": "703-222-6093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY ASSOCIATES OF NORTHERN VIRGINIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2007-11-13",
        "status": "A",
        "authorized_official_last_name": "MATTAY",
        "authorized_official_first_name": "NEERAJA",
        "authorized_official_middle_name": "CHARAGUNDLA",
        "authorized_official_title_or_position": "DR/OWNER",
        "authorized_official_telephone_number": "703-222-2773",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101047432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lenore L Day, M.D.
• Jacqueline Arnold De Conti, DPT
• Debra L. Tievsky, LCSW, PC
• Joseph Deleon, NCBTMB, OMT, CMRMP
• Dentists of Centreville PLLC
• Kari Montgomery Derohan, PT
• Devantrax Med Sollutions LLC
• Shriyam Dhakal, LCSW
• Melissa Anne Dhas, NP
• Diana O'Brien, LCSW. Med, LLC

• Specialist in Centreville, VA
• Providers in Centreville, VA by specialty
• Specialist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2007; 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.