Individual provider Active NPI

Ellen V Krieger, D.D.S.

  • Dentist
  • MC Lean, VA
National Provider Identifier
1295969434
Registry record updated May 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401007181 Issued in VA
Practice address
6707 Old Dominion Dr
Suite 230
MC Lean, VA 22101-4504
Phone
(703) 673-6363
Fax
(703) 893-3970
NPI assigned
May 1, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401007181 VA Primary

Addresses

Primary practice location

6707 Old Dominion Dr
Suite 230
MC Lean, VA 22101-4504

Mailing address

7448 Old Maple SQ
MC Lean, VA 22102-2817
Phone (703) 929-0998

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

LicenseStateTypeSpecialty
0401007181VAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1241136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241136000000",
    "number": "1295969434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7448 OLD MAPLE SQ",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221022817",
            "telephone_number": "703-929-0998",
            "fax_number": "703-893-3970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6707 OLD DOMINION DR",
            "address_2": "SUITE 230",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221014504",
            "telephone_number": "703-673-6363",
            "fax_number": "703-893-3970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRIEGER",
        "first_name": "ELLEN",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-01",
        "last_updated": "2009-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401007181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in MC Lean, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2009; 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.