NPIMap

Organization Active NPI

Tummarello and Pandak DDS, PC

  • General Practice Dentistry
  • Fairfax, VA
National Provider Identifier
1437370384
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
TUMMARELLO AND PANDAK DDS, PC
Practice address
11208 Waples Mill Rd Ste 101
Fairfax, VA 22030-6077
Phone
(703) 691-1511
NPI assigned
May 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Hilary Keith Pandak, DDSNPI 1417902800
Title
Partner
Phone
(703) 691-1511

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

11208 Waples Mill Rd Ste 101
Fairfax, VA 22030-6077

Mailing address

11208 Waples Mill Rd Ste 101
Fairfax, VA 22030-6077
Phone (703) 691-1511

National Provider Directory

National Provider Directory

Locations

11208 Waples Mill Rd
Ste 101
Fairfax, VA 22030
Phone (571) 723-2590

Practitioners & affiliated clinicians

Practitioners 2

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": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437370384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11208 WAPLES MILL RD STE 101",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306077",
            "telephone_number": "703-691-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11208 WAPLES MILL RD STE 101",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306077",
            "telephone_number": "703-691-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TUMMARELLO AND PANDAK DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PANDAK",
        "authorized_official_first_name": "HILARY",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "703-691-1511",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.