Let'S Smile of Fairfax PLLC

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

0401007980 Issued in VA

Legal business name

LET'S SMILE OF FAIRFAX PLLC

Practice address

4210 Fairfax Corner Ave W
Suite 245
Fairfax, VA 22030-8619

Phone

(703) 719-5828

Fax

(703) 691-8877

NPI assigned

Mar 30, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Ali Yousef Ghatri, DDS

Title

Chief Executive Officer

Phone

(703) 719-5828

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1333065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333065600000",
    "number": "1386910529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4210 FAIRFAX CORNER AVE W",
            "address_2": "SUITE 245",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220308619",
            "telephone_number": "703-719-5828",
            "fax_number": "703-691-8877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4210 FAIRFAX CORNER AVE W",
            "address_2": "SUITE 245",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220308619",
            "telephone_number": "703-719-5828",
            "fax_number": "703-691-8877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LET'S SMILE OF FAIRFAX PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-30",
        "last_updated": "2012-03-30",
        "status": "A",
        "authorized_official_last_name": "GHATRI",
        "authorized_official_first_name": "ALI",
        "authorized_official_middle_name": "YOUSEF",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "703-719-5828",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "VA",
            "license": "0401007980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Point of Service in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Point of Service in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2012; 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.