NPIMap

Organization Active NPI

Marcos Grande DDS PLLC

Doing business as Express Smiles

  • General Practice Dentistry
  • Herndon, VA
National Provider Identifier
1326462367
Registry record updated Feb 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401411982 Issued in VA
Legal business name
MARCOS GRANDE DDS PLLC
Doing business as
Express Smiles
Practice address
108 Elden St
10
Herndon, VA 20170-4828
Phone
(703) 471-7164
Fax
(703) 471-1801
NPI assigned
Feb 11, 2014
Last updated
Feb 11, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2014

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

Authorized official

Name
Marcos Grande, DDSNPI 1578765723
Title
Dentist
Phone
(703) 471-7164

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 0401411982 VA Primary

Addresses

Primary practice location

108 Elden St
10
Herndon, VA 20170-4828

Mailing address

108 Elden St
10
Herndon, VA 20170-4828
Phone (703) 471-7164

Other names 1

  • Express Smiles Doing business as

National Provider Directory

National Provider Directory

Locations

108 Elden St
Ste 10
Herndon, VA 20170
Phone (703) 471-7164

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1392076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392076800000",
    "number": "1326462367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 ELDEN ST",
            "address_2": "10",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704828",
            "telephone_number": "703-471-7164",
            "fax_number": "703-471-1801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 ELDEN ST",
            "address_2": "10",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704828",
            "telephone_number": "703-471-7164",
            "fax_number": "703-471-1801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARCOS GRANDE DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-11",
        "last_updated": "2014-02-11",
        "status": "A",
        "authorized_official_last_name": "GRANDE",
        "authorized_official_first_name": "MARCOS",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "703-471-7164",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401411982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Express Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Herndon, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2014; 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.