Jason W Dulac, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

0401414685 Issued in VA

Practice address

6124 Brandon Ave
Springfield, VA 22150-2610

Phone

(703) 451-4500

Fax

(703) 451-7164

NPI assigned

Jun 1, 2009

Last updated

Oct 20, 2020By the provider in NPPES

Sex

Male

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

Enrolled in VA

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

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jason W. Dulac, DDS, PLLC

  • General Practice Dentistry
  • Springfield, VA
  • NPI 1528501988
  NPD (past) Authorized official
• T James Batistas DDS PLLC

  dba Railroad Dental Associates

  • General Practice Dentistry
  • Manassas Park, VA
  • NPI 1457566903
  NPD (past)

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

{
    "created_epoch": "1243814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1356577613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6124 BRANDON AVE",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221502610",
            "telephone_number": "703-451-4500",
            "fax_number": "703-451-7164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6124 BRANDON AVE",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221502610",
            "telephone_number": "703-451-4500",
            "fax_number": "703-451-7164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DULAC",
        "first_name": "JASON",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-01",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901020024",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401414685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Tiffany Duong
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• Nima Dutt

• Dentist in Springfield, VA
• Providers in Springfield, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.