Elham Dehyar

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401416546 Issued in VA

Practice address

12989 Fair Lakes Shopping Ctr
Fairfax, VA 22033-5177

Phone

(703) 222-1230

NPI assigned

Jun 12, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fair Lakes Dental

  • General Practice Dentistry
  • Fairfax, VA
  • NPI 1548493885
  NPD (past)

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

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1285293209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24686 LENAH RD",
            "city": "ALDIE",
            "state": "VA",
            "postal_code": "201052324",
            "telephone_number": "703-332-1863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12989 FAIR LAKES SHOPPING CTR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220335177",
            "telephone_number": "703-222-1230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHYAR",
        "first_name": "ELHAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-12",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401416546",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401416546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John F. Defee, LCP
• Elizabeth Deffley
• Ashley Hannah Degeare, NDTR
• Lisa Degilio, NP
• Allison Maria Degregorio
• Joanne Dekis, MD
• Jan Jacob Dekker, MD,PHD,FACS
• Adriel Delacruz, DPT
• Marc Delaney, MD
• Elaine Delbianco, LCSW

• General Practice Dentistry in Fairfax, VA
• Providers in Fairfax, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2019; 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.