NPIMap

Organization Active NPI

Oak Tree Dental LLC

  • General Practice Dentistry
  • McLean, VA
National Provider Identifier
1316323546
Registry record updated Aug 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401414337 Issued in VA
Legal business name
OAK TREE DENTAL LLC
Practice address
8353 Greensboro Dr
Suite a & B
MC Lean, VA 22102-3530
Phone
(774) 212-3828
NPI assigned
Aug 11, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2015

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

Authorized official

Name
Kowshik R Vaddi, DMDNPI 1750583738
Title
Owner/Dentist
Phone
(774) 212-3828

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 0401414337 VA Primary

Addresses

Primary practice location

8353 Greensboro Dr
Suite a & B
MC Lean, VA 22102-3530

Mailing address

8353 Greensboro Dr
Suite a & B
MC Lean, VA 22102-3530
Phone (774) 212-3828

National Provider Directory

National Provider Directory

Locations

8353 Greensboro Dr
#A
Mc Lean, VA 22102
Phone (703) 763-5239

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1439251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439251200000",
    "number": "1316323546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8353 GREENSBORO DR",
            "address_2": "SUITE A & B",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221023530",
            "telephone_number": "774-212-3828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8353 GREENSBORO DR",
            "address_2": "SUITE A & B",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221023530",
            "telephone_number": "774-212-3828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK TREE DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-11",
        "last_updated": "2015-08-11",
        "status": "A",
        "authorized_official_last_name": "VADDI",
        "authorized_official_first_name": "KOWSHIK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "774-212-3828",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401414337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McLean, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2015; 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.