Active NPI
Karen Kozak, DDS
- General Practice Dentistry
- Falls Church, VA
National Provider Identifier
1487234381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 0401417157
- Practice address
- 800 W Broad St Ste 207
Falls Church, VA 22046-3144 - Phone
- (703) 998-4244
- NPI assigned
- Apr 13, 2021
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DEN2000094 | DC | |
| General Practice Dentistry | 1223G0001X | 17182 | MD | |
| General Practice Dentistry | 1223G0001X | 0401417157 | VA | Primary |
Addresses
Primary practice location
800 W Broad St Ste 207
Falls Church, VA 22046-3144
Mailing address
2470 Mandeville LN Apt 824
Alexandria, VA 22314-4891
Phone (913) 660-4187
Other practice location 1
510 Butler Ave
Martinsburg, WV 25405-9991
Phone (913) 660-4187
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 |
|---|---|---|---|
| DEN2000094 | DC | MD | General Practice Dentistry |
| 0401417157 | VA | MD | General Practice Dentistry |
| 17182 | MD | MD | Nutritionist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674086400000",
"number": "1487234381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2470 MANDEVILLE LN APT 824",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223144891",
"telephone_number": "913-660-4187"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 W BROAD ST STE 207",
"city": "FALLS CHURCH",
"state": "VA",
"postal_code": "220463144",
"telephone_number": "703-998-4244"
}
],
"practiceLocations": [
{
"address_1": "510 Butler Ave",
"address_purpose": "LOCATION",
"city": "Martinsburg",
"state": "WV",
"postal_code": "254059991",
"country_code": "US",
"telephone_number": "913-660-4187",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KOZAK",
"first_name": "KAREN",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-13",
"last_updated": "2023-01-19",
"certification_date": "2023-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "DC",
"license": "DEN2000094",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MD",
"license": "17182",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "VA",
"license": "0401417157",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Falls Church, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.