Jaklin Bezik, D.D.S., M.D.S.,

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

0401410580 Issued in VA

Practice address

11150 Fairfax Blvd
301
Fairfax, VA 22030-5066

Phone

(703) 934-4474

Fax

(703) 934-4705

NPI assigned

Feb 5, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 5, 2016 through Apr 5, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dr. Jaklin Bezik & Associates

  • Periodontics
  • Fairfax, VA
  • NPI 1780997288
  NPD (past) Authorized official
• Metro Dental Health PLLC

  • General Practice Dentistry
  • Washington, DC
  • NPI 1255789541
  NPD (past) Authorized official

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356480552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7073 IDYLWOOD RD",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220431527",
            "telephone_number": "703-448-3760",
            "fax_number": "703-448-3760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11150 FAIRFAX BLVD",
            "address_2": "301",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220305066",
            "telephone_number": "703-934-4474",
            "fax_number": "703-934-4705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEZIK",
        "first_name": "JAKLIN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.,  M.D.S.,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "VA",
            "license": "0401410580",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "DC",
            "license": "DEN1000297",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Bettwy, LCSW
• Caitlin Betz
• Roy A Beveridge, M.D.
• Beyond Closed Doors Therapy PLLC
• Beyond the Frame Therapeutics LLC
• BH Brightview Fair Oaks Opco, LLC
• BH Brightview Northfax Opco, LLC
• Mona Bhaskar, D.D.S.
• Sarah Bhatt, DNP, FNP-BC
• Aroob Bhatti

• Periodontics in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Periodontics in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.