NPIMap

Organization Active NPI

Dulles Orofacial Surgery

  • Ambulatory Surgical Clinic/Center
  • Chantilly, VA
National Provider Identifier
1467990895
Registry record updated Feb 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
0438000358 Issued in VA
Legal business name
DULLES OROFACIAL SURGERY
Practice address
24805 Pinebrook Rd
Suite 100
Chantilly, VA 20152-4126
Phone
(703) 327-0955
Fax
(703) 327-0956
NPI assigned
Feb 6, 2017
Last updated
Feb 6, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
DULLES ORAL SURGICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 6, 2017

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

Authorized official

Name
Edward Longwe, DDSNPI 1689886640
Title
Office Manager
Phone
(703) 327-0955

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 0438000358 VA Primary

Addresses

Primary practice location

24805 Pinebrook Rd
Suite 100
Chantilly, VA 20152-4126

Mailing address

24805 Pinebrook Rd
Suite 100
Chantilly, VA 20152-4126
Phone (703) 327-0955

National Provider Directory

National Provider Directory
Part of
Dulles Oral Surgical Center

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1486339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486339200000",
    "number": "1467990895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24805 PINEBROOK RD",
            "address_2": "SUITE 100",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201524126",
            "telephone_number": "703-327-0955",
            "fax_number": "703-327-0956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24805 PINEBROOK RD",
            "address_2": "SUITE 100",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201524126",
            "telephone_number": "703-327-0955",
            "fax_number": "703-327-0956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DULLES OROFACIAL SURGERY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DULLES ORAL SURGICAL CENTER",
        "enumeration_date": "2017-02-06",
        "last_updated": "2017-02-06",
        "status": "A",
        "authorized_official_last_name": "LONGWE",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "703-327-0955",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "VA",
            "license": "0438000358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chantilly, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2017; 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.