Active NPI
Ensiyeh Bateni
- Dentist
- Great Falls, VA
National Provider Identifier
1467152702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 0401418638
- Practice address
- 11115 Bowen Ave
Great Falls, VA 22066-1541 - Phone
- (571) 766-6188
- NPI assigned
- Mar 6, 2023
- Last updated
- Jan 15, 2025
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 0401418638 | VA | Primary |
Addresses
Primary practice location
11115 Bowen Ave
Great Falls, VA 22066-1541
Mailing address
11115 Bowen Ave
Great Falls, VA 22066-1541
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 |
|---|---|---|---|
| 0401418638 | VA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1678060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736899200000",
"number": "1467152702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11115 BOWEN AVE",
"city": "GREAT FALLS",
"state": "VA",
"postal_code": "220661541"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11115 BOWEN AVE",
"city": "GREAT FALLS",
"state": "VA",
"postal_code": "220661541",
"telephone_number": "571-766-6188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BATENI",
"first_name": "ENSIYEH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-06",
"last_updated": "2025-01-15",
"certification_date": "2025-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VA",
"license": "0401418638",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Great Falls, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.