NPIMap

Organization Active NPI

Mitra Hooshangi DDS, LLC

  • Dentist
  • Vienna, VA
National Provider Identifier
1497163638
Registry record updated Jul 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401007850 Issued in VA
Legal business name
MITRA HOOSHANGI DDS, LLC
Practice address
2112 Gallows Rd # D
Vienna, VA 22182-3963
Phone
(703) 893-7900
NPI assigned
Jul 31, 2014
Last updated
Jul 31, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2014

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

Authorized official

Name
Dr. Mitra HooshangiNPI 1609934231
Title
Dentist
Phone
(703) 893-7900

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
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 0401007850 VA Primary

Addresses

Primary practice location

2112 Gallows Rd # D
Vienna, VA 22182-3963

Mailing address

2112 Gallows Rd # D
Vienna, VA 22182-3963
Phone (703) 893-7900

National Provider Directory

National Provider Directory

Locations

2112 Gallows Rd
#D
Vienna, VA 22182
Phone (703) 893-7900

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": "1406764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406764800000",
    "number": "1497163638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2112 GALLOWS RD # D",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823963",
            "telephone_number": "703-893-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2112 GALLOWS RD # D",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823963",
            "telephone_number": "703-893-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MITRA HOOSHANGI DDS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-31",
        "last_updated": "2014-07-31",
        "status": "A",
        "authorized_official_last_name": "HOOSHANGI",
        "authorized_official_first_name": "MITRA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "703-893-7900",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401007850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vienna, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2014; 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.