NPIMap

Organization Active NPI

Fusion Dental

  • Dentist
  • Reston, VA
National Provider Identifier
1508445644
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
FUSION DENTAL
Practice address
11107 Sunset Hills Rd Ste 111
Reston, VA 20190-5375
Phone
(703) 860-3200
NPI assigned
Apr 6, 2021
Organization subpart
Yes
Parent organization
RESTON DENTAL GROUP, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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

Authorized official

Name
Jaime Byerly
Title
Director
Phone
(202) 699-1027

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

11107 Sunset Hills Rd Ste 111
Reston, VA 20190-5375

Mailing address

11107 Sunset Hills Rd Ste 111
Reston, VA 20190-5375
Phone (703) 860-3200

National Provider Directory

National Provider Directory
Tax ID family
Greater Maryland Dental Partners-Columbia8 organizations share this tax ID, including this one
Part of
Joseph Richardson DDS

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

11107 Sunset Hills Rd
Ste 111
Reston, VA 20190
Phone (703) 860-3200

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": "1617667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617667200000",
    "number": "1508445644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11107 SUNSET HILLS RD STE 111",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905375",
            "telephone_number": "703-860-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11107 SUNSET HILLS RD STE 111",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905375",
            "telephone_number": "703-860-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUSION DENTAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RESTON DENTAL GROUP, PC",
        "enumeration_date": "2021-04-06",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A",
        "authorized_official_last_name": "BYERLY",
        "authorized_official_first_name": "JAIME",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "202-699-1027"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2021; 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.