Dermatology Associates of Northern Virginia

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

0101047432 Issued in VA

Legal business name

DERMATOLOGY ASSOCIATES OF NORTHERN VIRGINIA

Practice address

25055 Riding PLZ
Suite 230
Chantilly, VA 20152-5917

Phone

(703) 222-2773

Fax

(703) 222-6093

NPI assigned

Mar 1, 2016

Last updated

Mar 1, 2016By 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

Ms. Anita June Neely

Title

Administrator

Phone

(703) 222-2773

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Neeraja Charagundla Mattay, M.D.

  • Specialist
  • Centreville, VA
  • NPI 1891721502
  NPD (past)

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

{
    "created_epoch": "1456790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456790400000",
    "number": "1255791448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13880 BRADDOCK RD STE 301",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201212462",
            "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": "25055 RIDING PLZ",
            "address_2": "SUITE 230",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201525917",
            "telephone_number": "703-222-2773",
            "fax_number": "703-222-6093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY ASSOCIATES OF NORTHERN VIRGINIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-01",
        "last_updated": "2016-03-01",
        "status": "A",
        "authorized_official_last_name": "NEELY",
        "authorized_official_first_name": "ANITA",
        "authorized_official_middle_name": "JUNE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "703-222-2773",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "VA",
            "license": "0101047432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leilani Dellinger
• Dental One Associates South Riding PC
• Dental Professionals of Virginia, P.C. (Gum Springs Dental Care)
• Teresa Denton
• Sanaz Derakhshan
• Derocco Health and Wellness Inc (Premier Birth Center Chantilly)
• Derocco Health and Wellness Inc
• Emily Derocco, D.C.
• Marc Bosco Desa
• Desai Physical Therapy, PLLC

• Preferred Provider Organization in Chantilly, VA
• Providers in Chantilly, VA by specialty
• Preferred Provider Organization in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2016; 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.