Organization Active NPI

Sasan Ahmadiyar, DDS,PLLC

  • General Practice Dentistry
  • Alexandria, VA
National Provider Identifier
1396259586
Registry record updated Nov 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401008767 Issued in VA
Legal business name
SASAN AHMADIYAR, DDS,PLLC
Practice address
1911 Ballenger Ave
Alexandria, VA 22314-6819
Phone
(703) 299-1200
NPI assigned
Nov 27, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2017

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

Authorized official

Name
Dr. Sasan Ahmadiyar, DDS
Title
Dentist
Phone
(703) 299-1200

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 0401008767 VA Primary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X

Addresses

Primary practice location

1911 Ballenger Ave
Alexandria, VA 22314-6819

Mailing address

10608 Leavells Rd
Fredericksburg, VA 22407-1256
Phone (540) 710-6000

Other identifiers 1

IdentifierTypeStateIssuer
1699801787MedicaidVA

National Provider Directory

National Provider Directory

Locations

1911 Ballenger Ave
Alexandria, VA 22314
Phone (703) 299-1200

NPI Registry JSON

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

{
    "created_epoch": "1511740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511740800000",
    "number": "1396259586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10608 LEAVELLS RD",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224071256",
            "telephone_number": "540-710-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 BALLENGER AVE",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223146819",
            "telephone_number": "703-299-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SASAN AHMADIYAR, DDS,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-27",
        "last_updated": "2017-11-27",
        "status": "A",
        "authorized_official_last_name": "AHMADIYAR",
        "authorized_official_first_name": "SASAN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "703-299-1200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401008767",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699801787",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2017; 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.