Irelsy Alexandra Rivera Velazquez, DMD, MSD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

0401417865 Issued in VA

Practice address

7611 Little River Tpke Ste 101E
Annandale, VA 22003-2630

Phone

(787) 949-5828

NPI assigned

Apr 16, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1460764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657497600000",
    "number": "1538513536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7611 LITTLE RIVER TPKE STE 101E",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220032630",
            "telephone_number": "703-634-4195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7611 LITTLE RIVER TPKE STE 101E",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220032630",
            "telephone_number": "787-949-5828"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2020 Opitz Blvd Ste A",
            "address_purpose": "LOCATION",
            "city": "Woodbridge",
            "state": "VA",
            "postal_code": "221913356",
            "country_code": "US",
            "telephone_number": "703-634-4238",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVERA VELAZQUEZ",
        "first_name": "IRELSY",
        "middle_name": "ALEXANDRA",
        "name_prefix": "Dr.",
        "credential": "DMD, MSD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-16",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "VA",
            "license": "0401417865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Lea Rice, M.A. CCC-SLP
• Tae Yong Rim, L.AC.
• Morgan Bishop Ritacco, LICSW
• Riley Ritchie, M.A. CF-SLP
• Ricardo Adrian Rius, M.D., PH.D.
• Ann I. Rixinger, M.D.
• Ohsang Nmi Ro, M.D.
• Robert a Breiner PC
• Robert M. Gorsen M.D.,PHD.,P.C.
• Madeleine Claire Roberts, MD

• Oral and Maxillofacial Surgery (Dentist) in Annandale, VA
• Providers in Annandale, VA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.