NPIMap

Organization Active NPI

Sudley Family Dentistry

  • Dentist
  • Manassas, VA
National Provider Identifier
1285062737
Registry record updated Oct 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401411140 Issued in VA
Legal business name
SUDLEY FAMILY DENTISTRY
Practice address
8739 Plantation LN
Manassas, VA 20110-4506
Phone
(703) 368-0704
NPI assigned
Oct 21, 2013
Last updated
Oct 21, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2013

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

Authorized official

Name
Dr. Long Nguyen, DDS
Title
President
Phone
(646) 641-8825

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 0401411140 VA Primary

Addresses

Primary practice location

8739 Plantation LN
Manassas, VA 20110-4506

Mailing address

7915 Lake Manassas Dr
Suite 115
Gainesville, VA 20155-3258

National Provider Directory

National Provider Directory

Locations

7915 Lake Manassas Dr
Ste 115
Gainesville, VA 20155
Phone (571) 261-9470

8739 Plantation Ln
Manassas, VA 20110
Phone (703) 368-0704

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1382313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382313600000",
    "number": "1285062737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7915 LAKE MANASSAS DR",
            "address_2": "SUITE 115",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201553258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8739 PLANTATION LN",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104506",
            "telephone_number": "703-368-0704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUDLEY FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-21",
        "last_updated": "2013-10-21",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "LONG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "646-641-8825",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401411140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.