Distinctive Dermatology PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

DISTINCTIVE DERMATOLOGY PLLC

Practice address

8603 Westwood Center Dr Ste 320
Vienna, VA 22182-2230

Phone

(703) 570-1192

Fax

(703) 382-6654

NPI assigned

Jul 9, 2024

Organization subpart

No

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

Authorized official

Name

Amber Atwater, MDNPI 1548222151

Title

Manager

Phone

(919) 239-0126

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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

• Amber R Atwater, M.D.

  • Dermatology Physician
  • Vienna, VA
  • NPI 1548222151

  DC

  Medicare reassignment NPD Authorized official
• Philip R Effraim, MD PHD

  • Anesthesiology Physician
  • New Haven, CT
  • NPI 1427347616
  NPD

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

{
    "created_epoch": "1720483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735776000000",
    "number": "1386481109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64",
            "city": "GREAT FALLS",
            "state": "VA",
            "postal_code": "220660064",
            "telephone_number": "703-570-1192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8603 WESTWOOD CENTER DR STE 320",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822230",
            "telephone_number": "703-570-1192",
            "fax_number": "703-382-6654"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8605 Westwood Center Dr Ste 201",
            "address_purpose": "LOCATION",
            "city": "Vienna",
            "state": "VA",
            "postal_code": "221822231",
            "country_code": "US",
            "telephone_number": "703-570-1192",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DISTINCTIVE DERMATOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-09",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A",
        "authorized_official_last_name": "ATWATER",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "919-239-0126",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Hilario Diaz, DMD, MS
• Dina Edelbi DMD PLLC
• Vostina Dinovo, PHD
• Brenda Dintiman, M.D.
• Cristina Carmen Dinunzio, PT
• Robert Elio Divalentin, DDS
• Denise Diver-Laver, O.T.
• Petya Djoubrailov, PT
• DKDC Orthodontics PLLC
• DMV Smile LLC

• Dermatology Physician in Vienna, VA
• Providers in Vienna, VA by specialty
• Dermatology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.