Anh H Pham DDS & Barry R Maharaj DDS PC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

0401006304 Issued in VA

Legal business name

ANH H PHAM DDS & BARRY R MAHARAJ DDS PC

Doing business as

Chantilly Oral Surgery

Practice address

3910 Centerville Rd
Ste 110
Chantilly, VA 20151-3280

Phone

(703) 668-9494

Fax

(703) 668-9495

NPI assigned

Aug 20, 2006

Last updated

Jun 27, 2013By 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

Mrs. Kaiti Rose Grim, CMOM CERT MEDICAL OF

Title

Administrative Director

Phone

(703) 668-9494

Specialties & licenses 2

Addresses

Other identifiers 7

Other names 1

• Chantilly Oral Surgery Doing business as

Locations

Practitioners 3

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.

• Barry R Maharaj, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Lansdowne, VA
  • NPI 1205856515
  NPD (past)
• Anh Huu Pham, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Lansdowne, VA
  • NPI 1750325361
  NPD (past)
• Ayesha Nawab, DMD, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Frederick, MD
  • NPI 1225299225
  NPD (past)

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372291200000",
    "number": "1265547947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3910 CENTERVILLE RD",
            "address_2": "STE 110",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201513280",
            "telephone_number": "703-668-9494",
            "fax_number": "703-668-9495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3910 CENTERVILLE RD",
            "address_2": "STE 110",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201513280",
            "telephone_number": "703-668-9494",
            "fax_number": "703-668-9495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANH H PHAM DDS & BARRY R MAHARAJ DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2013-06-27",
        "status": "A",
        "authorized_official_last_name": "GRIM",
        "authorized_official_first_name": "KAITI",
        "authorized_official_middle_name": "ROSE",
        "authorized_official_title_or_position": "ADMINISTRATIVE DIRECTOR",
        "authorized_official_telephone_number": "703-668-9494",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CMOM CERT MEDICAL OF"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "VA",
            "license": "0401006304",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "VA",
            "license": "0401410305",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIGON BCBS ANTHEM",
            "identifier": "105289",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI OPT CHOICE ALLIANCE",
            "identifier": "392375",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI OPT CHOICE ALLIANCE",
            "identifier": "555676",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIGON BCBS ANTHEM",
            "identifier": "105288",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1667155",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "1006881",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1696192",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chantilly Oral Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Emma Anderson
• Judit Andrade Cruz
• Joann W Andriko, MD
• Angel Senior Home Care LLC (Attend Home Care)
• Claudia P Angel, PA-C
• Mathilde Sarah Lisa Anik Vedel
• Swapnika Ankana, D.P.T.
• Vidya K Annamreddy
• Annandale Medical Associates PC
• Nymisha Anne

• Oral and Maxillofacial Surgery (Dentist) in Chantilly, VA
• Providers in Chantilly, VA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2013; 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.