Individual provider Active NPI

Johana Nieto, DDS

  • General Practice Dentistry
  • Falls Church, VA
National Provider Identifier
1508936998
Registry record updated Sep 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401411219 Issued in VA
Practice address
800 W Broad St
Suite 304
Falls Church, VA 22046-3106
Phone
(703) 237-3516
NPI assigned
Nov 9, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0401411219 VA Primary

Addresses

Primary practice location

800 W Broad St
Suite 304
Falls Church, VA 22046-3106

Mailing address

800 W Broad St
Suite 304
Falls Church, VA 22046-3142
Phone (703) 237-3516

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160318001314 DC Order and Referring Only - DentistPractitioner - Dentist 3870890833

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348185600000",
    "number": "1508936998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 W BROAD ST",
            "address_2": "SUITE 304",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220463142",
            "telephone_number": "703-237-3516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W BROAD ST",
            "address_2": "SUITE 304",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220463106",
            "telephone_number": "703-237-3516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIETO",
        "first_name": "JOHANA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2012-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401411219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Falls Church, VA

Sources for this page

Verify at the official NPI Registry.