NPIMap

Organization Active NPI

Anderson & Barragan Dental Associates

  • General Practice Dentistry
  • Manassas, VA
National Provider Identifier
1417501511
Registry record updated Jul 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
ANDERSON & BARRAGAN DENTAL ASSOCIATES
Practice address
9380 Forestwood LN Ste E
Manassas, VA 20110-4735
Phone
(703) 368-4344
NPI assigned
Jul 26, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2019

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

Authorized official

Name
Joshua Wilfredo Anderson, DDSNPI 1912105438
Title
Owner
Phone
(860) 817-2787

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary
Dental Clinic/Center 261QD0000X

Addresses

Primary practice location

9380 Forestwood LN Ste E
Manassas, VA 20110-4735

Mailing address

9380 Forestwood LN Ste E
Manassas, VA 20110-4735
Phone (703) 368-4344

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@renovasmiles.com

National Provider Directory

National Provider Directory

Locations

9380 Forestwood Ln
Ste E
Manassas, VA 20110
Phone (703) 368-4344

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1564099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564099200000",
    "number": "1417501511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9380 FORESTWOOD LN STE E",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104735",
            "telephone_number": "703-368-4344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9380 FORESTWOOD LN STE E",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104735",
            "telephone_number": "703-368-4344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDERSON & BARRAGAN DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-26",
        "last_updated": "2019-07-26",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "WILFREDO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-817-2787",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@renovasmiles.com",
            "affiliation": "N",
            "address_1": "9380 Forestwood Ln Ste E",
            "city": "Manassas",
            "state": "VA",
            "country_code": "US",
            "postal_code": "201104735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2019; 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.