Bruce Taheri, DDS, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401410248 Issued in VA

Legal business name

BRUCE TAHERI, DDS, PC

Practice address

3114 Golansky Blvd
Suite 102
Woodbridge, VA 22192-4231

Phone

(703) 583-2800

Fax

(703) 583-2801

NPI assigned

Aug 16, 2007

Last updated

Aug 16, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bruce Taheri, DDS

Title

Dentist/Owner

Phone

(202) 528-1820

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187222400000",
    "number": "1538351234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3114 GOLANSKY BLVD",
            "address_2": "SUITE 102",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221924231",
            "telephone_number": "703-583-2800",
            "fax_number": "703-583-2801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3114 GOLANSKY BLVD",
            "address_2": "SUITE 102",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221924231",
            "telephone_number": "703-583-2800",
            "fax_number": "703-583-2801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE TAHERI, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-16",
        "last_updated": "2007-08-16",
        "status": "A",
        "authorized_official_last_name": "TAHERI",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "202-528-1820",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401410248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2007; 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.