Active NPI
Taimour Jan Raja, D.D.S.
- General Practice Dentistry
- Reston, VA
National Provider Identifier
1417137357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 0401411994
- Practice address
- 11700 Plaza America Dr Ste 140
Reston, VA 20190-4753 - Phone
- (434) 249-3793
- NPI assigned
- Nov 8, 2007
- Last updated
- Aug 31, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 0401411994 | VA | Primary |
Addresses
Primary practice location
11700 Plaza America Dr Ste 140
Reston, VA 20190-4753
Mailing address
1366 Singleton LN
Charlottesville, VA 22903-8803
Phone (434) 409-3893
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 |
|---|---|---|---|
| 0401411994 | VA | MD | General Practice Dentistry |
Organizations & group practices 1
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": "1194480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630368000000",
"number": "1417137357",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1366 SINGLETON LN",
"city": "CHARLOTTESVILLE",
"state": "VA",
"postal_code": "229038803",
"telephone_number": "434-409-3893"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11700 PLAZA AMERICA DR STE 140",
"city": "RESTON",
"state": "VA",
"postal_code": "201904753",
"telephone_number": "434-249-3793"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAJA",
"first_name": "TAIMOUR",
"middle_name": "JAN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-11-08",
"last_updated": "2021-08-31",
"certification_date": "2021-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "VA",
"license": "0401411994",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Reston, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.