Individual provider Active NPI

Korosh Eric Armakan, DDS

  • Pediatric Dentistry
  • Potomac, MD
National Provider Identifier
1417214396
Registry record updated Dec 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
15357 Issued in MD
Practice address
9812 Falls Rd Ste 118
Potomac, MD 20854-3918
Phone
(301) 983-9804
NPI assigned
Apr 18, 2012
Last updated
Dec 15, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DEN1001159 DC
Pediatric Dentistry 1223P0221X 0401413952 VA
Pediatric Dentistry 1223P0221X 15357 MD Primary

Addresses

Primary practice location

9812 Falls Rd Ste 118
Potomac, MD 20854-3918

Mailing address

1416 N Monroe St
Arlington, VA 22201-4903
Phone (703) 868-4435

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

LicenseStateTypeSpecialty
15357MDMDClinical Social Worker
DEN1001159DCMDDentist
0401413952VAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Amy Light, DMD, PC Pediatric Dentistry PastSince Dec 22, 2020 Accepting new patients

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": "1334707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1417214396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1416 N MONROE ST",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222014903",
            "telephone_number": "703-868-4435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9812 FALLS RD STE 118",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208543918",
            "telephone_number": "301-983-9804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARMAKAN",
        "first_name": "KOROSH",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-18",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "DC",
            "license": "DEN1001159",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "VA",
            "license": "0401413952",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MD",
            "license": "15357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Potomac, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.

Verify at the official NPI Registry.