Centreville Optometry, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618000041 Issued in VA

Legal business name

CENTREVILLE OPTOMETRY, LLC

Practice address

14245E Centreville SQ
Centreville, VA 20121-2368

Phone

(703) 830-2010

Fax

(703) 818-7014

NPI assigned

Aug 9, 2007

Organization subpart

No

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

Authorized official

Name

John W. Dresely, OD

Title

Secretary

Phone

(703) 830-2010

Specialties & licenses 1

Addresses

Other names 1

• My Eye Dr. Doing business as

Locations

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

{
    "created_epoch": "1186617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653436800000",
    "number": "1306037734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14245E CENTREVILLE SQ",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201212368",
            "telephone_number": "703-830-2010",
            "fax_number": "703-818-7014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTREVILLE OPTOMETRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-09",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A",
        "authorized_official_last_name": "DRESELY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "703-830-2010",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "My Eye Dr.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "My Eye Dr.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Centreville Dental Wellness Center,PC.
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• Centreville Family Practice
• Centreville Internal Medicine
• Centreville Medical Practice PLLC
• Centreville Pediatric Dentistry PLLC
• Centreville Physical Therapy, PC
• Centreville Women'S Health LLC
• Centreville-Chantilly Family Practice
• Navneen Chahal, PA-C

• Optometrist in Centreville, VA
• Providers in Centreville, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2022; 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.