Individual provider Active NPI

Claudia Marcela Ardila Gaitan, D.D.S.

  • Dentist
  • Arlington, VA
National Provider Identifier
1306133400
Registry record updated Sep 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401414022 Issued in VA
Practice address
2445 Army Navy Dr
Suite 305
Arlington, VA 22206-2905
Phone
(703) 535-5568
NPI assigned
Jul 9, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401414022 VA Primary

Addresses

Primary practice location

2445 Army Navy Dr
Suite 305
Arlington, VA 22206-2905

Mailing address

2445 Army Navy Dr
Suite 104
Arlington, VA 22206-2905
Phone (703) 535-5568

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20160517000063 PA Order and Referring Only - DentistPractitioner - Dentist 1456640341

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1310169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409702400000",
    "number": "1306133400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2445 ARMY NAVY DR",
            "address_2": "SUITE 104",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222062905",
            "telephone_number": "703-535-5568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2445 ARMY NAVY DR",
            "address_2": "SUITE 305",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222062905",
            "telephone_number": "703-535-5568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARDILA GAITAN",
        "first_name": "CLAUDIA",
        "middle_name": "MARCELA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-09",
        "last_updated": "2014-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401414022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, VA

Sources for this page

Verify at the official NPI Registry.