Walnut Dental Associates, LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

WALNUT DENTAL ASSOCIATES, LLC

Practice address

3930 Walnut St Ste 240
Fairfax, VA 22030-4738

Phone

(703) 638-1420

Fax

(703) 638-1421

NPI assigned

Feb 4, 2021

Last updated

Feb 4, 2021By 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

Dr. Rolin S Henry, DDSNPI 1720259807

Title

Member

Phone

(703) 638-1420

Specialties & licenses 2

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.

• Rolin S. Henry, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Alexandria, VA
  • NPI 1720259807
  NPD Authorized official

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

{
    "created_epoch": "1612396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612396800000",
    "number": "1275125809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3930 WALNUT ST STE 240",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220304738",
            "telephone_number": "703-638-1420",
            "fax_number": "703-638-1421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3930 WALNUT ST STE 240",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220304738",
            "telephone_number": "703-638-1420",
            "fax_number": "703-638-1421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALNUT DENTAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-04",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A",
        "authorized_official_last_name": "HENRY",
        "authorized_official_first_name": "ROLIN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "703-638-1420",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jarrod Wallace
• Tara Banks Wallace, PSY.D.
• Hannah L Wallen, PA
• Charles Cutez Waller, PSY.D.
• Rachel Walls, LCSW
• Kathryn Walseman
• Kaelie Jager Walsh, PT, DPT
• Barry F. Walter, M.D.
• Christopher J Walters, DPM
• Lee Walters, P.A.-C

• Oral and Maxillofacial Surgery (Dentist) in Fairfax, VA
• Providers in Fairfax, 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 Feb 4, 2021; 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.