Active NPI
Saif Kargoli, DDS
- Endodontics
- Chantilly, VA
National Provider Identifier
1396153375
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 0401415175
- Practice address
- 14337 Newbrook Dr Ste 200
Chantilly, VA 20151-4259 - Phone
- (703) 214-2113
- NPI assigned
- Jul 23, 2014
- Last updated
- Apr 24, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 0401415175 | VA | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | 1340 | FL | |
| Student in an Organized Health Care Education/Training Program | 390200000X | NY |
Addresses
Primary practice location
14337 Newbrook Dr Ste 200
Chantilly, VA 20151-4259
Mailing address
100 Haven Ave
New York, NY 10032-2645
Phone (703) 214-2113
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401415175 | VA | MD | Endodontist |
| 1340 | FL | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Endodontics PLLC | Endodontics | Current | Accepting new patients |
| Chantilly Modern Dentistry, PC | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1406073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1587686400000",
"number": "1396153375",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 HAVEN AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100322645",
"telephone_number": "703-214-2113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14337 NEWBROOK DR STE 200",
"city": "CHANTILLY",
"state": "VA",
"postal_code": "201514259",
"telephone_number": "703-214-2113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KARGOLI",
"first_name": "SAIF",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-07-23",
"last_updated": "2020-04-24",
"certification_date": "2020-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "VA",
"license": "0401415175",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "FL",
"license": "1340",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NY",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chantilly, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.