Active NPI
Tirdad Fattahi
- General Practice Dentistry
- Washington, DC
National Provider Identifier
1295836799
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 4810
- Practice address
- 4840 Macarthur Blvd., NW
Suite 101
Washington, DC 20007-2550 - Phone
- (202) 338-7499
- Fax
- (202) 338-8745
- NPI assigned
- Sep 26, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4810 | DC | Primary |
Addresses
Primary practice location
4840 Macarthur Blvd., NW
Suite 101
Washington, DC 20007-2550
Mailing address
4840 Macarthur Blvd NW
Suite 101
Washington, DC 20007-1565
Phone (202) 338-7499
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4810 | DC | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285286400000",
"number": "1295836799",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4840 MACARTHUR BLVD NW",
"address_2": "SUITE 101",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200071565",
"telephone_number": "202-338-7499",
"fax_number": "202-338-8745"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4840 MACARTHUR BLVD., NW",
"address_2": "SUITE 101",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200072550",
"telephone_number": "202-338-7499",
"fax_number": "202-338-8745"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FATTAHI",
"first_name": "TIRDAD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-26",
"last_updated": "2010-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "DC",
"license": "4810",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.