Dulles Family Medicine P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0101046800 Issued in VA

Legal business name

DULLES FAMILY MEDICINE P.C.

Practice address

504 Elden St # 3
Herndon, VA 20170-4741

Phone

(703) 471-0800

Fax

(703) 471-1332

NPI assigned

Jul 12, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shamim Akhtar Iman, M.D.

Title

Owner of Practice C Corporation

Phone

(703) 471-0800

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Locations

Practitioners 2

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.

• Shamim Akhtar Imam, M.D.

  • Family Medicine Physician
  • Herndon, VA
  • NPI 1265513550

  DC

  Medicare reassignment NPD
• Shabih U Hasan, MD

  • Specialist
  • Herndon, VA
  • NPI 1205908761
  NPD (past)

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295760510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 ELDEN ST # 3",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704741",
            "telephone_number": "703-471-0800",
            "fax_number": "703-471-1332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 ELDEN ST # 3",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704741",
            "telephone_number": "703-471-0800",
            "fax_number": "703-471-1332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DULLES FAMILY MEDICINE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "IMAN",
        "authorized_official_first_name": "SHAMIM",
        "authorized_official_middle_name": "AKHTAR",
        "authorized_official_title_or_position": "OWNER OF PRACTICE C CORPORATION",
        "authorized_official_telephone_number": "703-471-0800",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101046800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neelam Jhawar Dube, D.D.S.
• William Dubiel, DPT
• Ruth Kathleen Duchatellier-Cange, D.D.S
• Claire Ellen Dulin Ortiz, DPT
• Dulles Dental Center, P.C.
• Rebecca Ashley Dumas, BCBA
• Churchill G Dunn II, MD
• Jennifer Dunstan
• Ayefa Saleem Durrani
• Eagleforce Associates Inc

• Family Medicine Physician in Herndon, VA
• Providers in Herndon, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.