Ridgetop Dental of Reston, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

RIDGETOP DENTAL OF RESTON, PLLC

Practice address

1939 Roland Clarke PL Ste 120
Reston, VA 20191-1445

Phone

(571) 313-0607

NPI assigned

Feb 5, 2024

Organization subpart

No

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

Authorized official

Name

Dattathri Malyavantham, DDS

Title

Owner

Phone

(571) 313-0607

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Diana Vartui Sensenbrenner, D.D.S.

  • Dentist
  • Sterling, VA
  • NPI 1225303704
  NPD
• Christian Keith Hart, DDS

  • General Practice Dentistry
  • Belmont, NC
  • NPI 1205495074
  NPD (past)

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

{
    "created_epoch": "1707091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707091200000",
    "number": "1295598985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1939 ROLAND CLARKE PL STE 120",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201911445",
            "telephone_number": "571-313-0607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1939 ROLAND CLARKE PL STE 120",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201911445",
            "telephone_number": "571-313-0607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGETOP DENTAL OF RESTON, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-05",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A",
        "authorized_official_last_name": "MALYAVANTHAM",
        "authorized_official_first_name": "DATTATHRI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "571-313-0607",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph L. Richardson III, DDS
• Rachel Marie Richardson
• Abigail Charlotte Richter, LCSW
• Jonette Ricks
• India Riddle
• Tyrinda Lanese Riley
• Risen Medical Care Inc
• Lawrence Philip Riso, PH.D.
• Lyle Joseph Ritch, PA
• Linda Gail Ritchie, LMFT

• Dental Clinic/Center in Reston, VA
• Providers in Reston, VA by specialty
• Dental Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; 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.