NPIMap

Organization Active NPI

Reston Dental Group, PC

  • Dental Clinic/Center
  • Reston, VA
National Provider Identifier
1427128669
Registry record updated Apr 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
RESTON DENTAL GROUP, PC
Practice address
11107 Sunset Hills Rd Ste 111
Reston, VA 20190-5481
Phone
(703) 860-3200
Fax
(703) 391-8228
NPI assigned
Nov 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2022

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

Authorized official

Name
Ms. Carol Lynn Mohammed
Title
Business Manager
Phone
(703) 860-3200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X VA Primary

Addresses

Primary practice location

11107 Sunset Hills Rd Ste 111
Reston, VA 20190-5481

Mailing address

11107 Sunset Hills Rd Ste 111
Reston, VA 20190-5481
Phone (703) 860-3200

National Provider Directory

National Provider Directory
Tax ID family
Joseph Richardson DDS2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

11503 Sunrise Valley Dr
Reston, VA 20191
Phone (703) 860-3200

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649808000000",
    "number": "1427128669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11107 SUNSET HILLS RD STE 111",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905481",
            "telephone_number": "703-860-3200",
            "fax_number": "703-391-8228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11107 SUNSET HILLS RD STE 111",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905481",
            "telephone_number": "703-860-3200",
            "fax_number": "703-391-8228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTON DENTAL GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A",
        "authorized_official_last_name": "MOHAMMED",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "703-860-3200",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "VA",
            "license": null,
            "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 Apr 13, 2022; 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.