Individual provider Active NPI

Mestire Solomon, DMD

  • Dentist
  • Washington, DC
National Provider Identifier
1295045490
Registry record updated Nov 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DEN1000982 Issued in DC
Practice address
1220 12TH St SE
Washington, DC 20003-3722
Phone
(202) 715-7900
NPI assigned
Oct 21, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 14598 MD
Dentist 122300000X DEN1000982 DC Primary

Addresses

Primary practice location

1220 12TH St SE
Washington, DC 20003-3722

Mailing address

9004 Nesbit CT
Montgomery Village, MD 20886-4019
Phone (617) 869-9788

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160505001934 DC Order and Referring Only - DentistPractitioner - Dentist 5496054827

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DEN1000982DCMDDentist
14598MDMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Dental Dentist CurrentSince Feb 19, 2023 Accepting new patients
Cos LLC Current Accepting new patients

Locations

611 S Carlin Springs Rd
Ste 408
Arlington, VA 22204
Phone (703) 671-7500

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1287619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353974400000",
    "number": "1295045490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9004 NESBIT CT",
            "city": "MONTGOMERY VILLAGE",
            "state": "MD",
            "postal_code": "208864019",
            "telephone_number": "617-869-9788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 12TH ST SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200033722",
            "telephone_number": "202-715-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLOMON",
        "first_name": "MESTIRE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-21",
        "last_updated": "2012-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "14598",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "DC",
            "license": "DEN1000982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.