Individual provider Active NPI

John Greaton Sellers Jr., DDS

  • General Practice Dentistry
  • Fairfax, VA
National Provider Identifier
1518989854
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401004933 Issued in VA
Practice address
3879 Plaza Dr
Fairfax, VA 22030-2512
Phone
(703) 691-9041
Fax
(703) 691-9239
NPI assigned
Jul 24, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 0401004933 VA Primary

Addresses

Primary practice location

3879 Plaza Dr
Fairfax, VA 22030-2512

Mailing address

3879 Plaza Dr
Fairfax, VA 22030-2512
Phone (703) 352-5814

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20170215000754 VA Order and Referring Only - DentistPractitioner - Dentist 3072896117

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jones Family Dentistry PLLC General Practice PastSince Jul 24, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1518989854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3879 PLAZA DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302512",
            "telephone_number": "703-352-5814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3879 PLAZA DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302512",
            "telephone_number": "703-691-9041",
            "fax_number": "703-691-9239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELLERS",
        "first_name": "JOHN",
        "middle_name": "GREATON",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401004933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.