South Riding Oral and Implant Surgery

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

SOUTH RIDING ORAL AND IMPLANT SURGERY

Doing business as

South Riding Oral and Implant Surgery

Practice address

24805 Pinebrook Rd # 318
Chantilly, VA 20152-4126

Phone

(571) 218-0878

NPI assigned

Jul 3, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Kamran Raja, DMD, MDNPI 1528101805

Title

Owner

Phone

(571) 218-0878

Specialties & licenses 1

Addresses

Other names 1

• South Riding Oral and Implant Surgery Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kamran Nawaz Raja, DMD, MD, FACS

  • Oral and Maxillofacial Surgery (Dentist)
  • Chantilly, VA
  • NPI 1528101805
  NPD (past) Authorized official

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

{
    "created_epoch": "1562112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562112000000",
    "number": "1285296814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9209 MAROVELLI FOREST DR",
            "city": "LORTON",
            "state": "VA",
            "postal_code": "220793456",
            "telephone_number": "571-218-0878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24805 PINEBROOK RD # 318",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201524126",
            "telephone_number": "571-218-0878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH RIDING ORAL AND IMPLANT SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-03",
        "last_updated": "2019-07-03",
        "status": "A",
        "authorized_official_last_name": "RAJA",
        "authorized_official_first_name": "KAMRAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "571-218-0878",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, MD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Riding Oral and Implant Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Scott Song, OD
• Rafael Angel Soriano Sr., MSN, ARNP - FNP
• Ramsey Peter Sosola, BT
• South Riding Family Chiropractic Center
• South Riding Modern Dentistry, PC
• Samantha L Sova, PT, DPT
• Wendy Pampam Sowah, RN
• Spectrum Learning
• Stephen Spiker
• Emily Spina

• 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 Jul 3, 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.