Individual provider Active NPI

Dean Gordon Rye, D.D.S.

  • General Practice Dentistry
  • Fairfax, VA
National Provider Identifier
1407948136
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401006135 Issued in VA
Practice address
10614 Warwick Ave Ste a
Fairfax, VA 22030-3060
Phone
(703) 352-2010
Fax
(703) 591-9408
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0401006135 VA Primary

Addresses

Primary practice location

10614 Warwick Ave Ste a
Fairfax, VA 22030-3060

Mailing address

10614 Warwick Ave Ste a
Fairfax, VA 22030-3060
Phone (703) 352-2010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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

Enrollment IDStateProvider typePAC IDDetails
I20170601000511 DC Order and Referring Only - DentistPractitioner - Dentist 3375810088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407948136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10614 WARWICK AVE STE A",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220303060",
            "telephone_number": "703-352-2010",
            "fax_number": "703-591-9408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10614 WARWICK AVE STE A",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220303060",
            "telephone_number": "703-352-2010",
            "fax_number": "703-591-9408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYE",
        "first_name": "DEAN",
        "middle_name": "GORDON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401006135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.