Individual provider Active NPI

Touraj Kamali, DDS

  • General Practice Dentistry
  • Fairfax, VA
National Provider Identifier
1295900892
Registry record updated Sep 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401008249 Issued in VA
Practice address
10611 Judicial Dr
Fairfax, VA 22030-5165
Phone
(703) 385-0303
Fax
(703) 385-1445
NPI assigned
Apr 24, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0401008249 VA Primary

Addresses

Primary practice location

10611 Judicial Dr
Fairfax, VA 22030-5165

Mailing address

10611 Judicial Dr
Fairfax, VA 22030-5165
Phone (703) 385-0303

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20161004000707 VA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3476841693

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0401008249VAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Charles D, Kirksey, DDS, LLC General Practice Past Accepting new patients

Organizations & group practices 1

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": "1208995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473984000000",
    "number": "1295900892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10611 JUDICIAL DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220305165",
            "telephone_number": "703-385-0303",
            "fax_number": "703-385-1445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10611 JUDICIAL DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220305165",
            "telephone_number": "703-385-0303",
            "fax_number": "703-385-1445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMALI",
        "first_name": "TOURAJ",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-24",
        "last_updated": "2016-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401008249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.