Active NPI
Sanford Brotman, D.D.S.
- General Practice Dentistry
- Falls Church, VA
National Provider Identifier
1548481237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 0401003206
- Practice address
- 5827 Columbia Pike
Suite 405
Falls Church, VA 22041 - Phone
- (703) 820-7170
- NPI assigned
- May 1, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 0401003206 | VA | Primary |
Addresses
Primary practice location
5827 Columbia Pike
Suite 405
Falls Church, VA 22041
Mailing address
3318 Mantua Drive
Fairfax, VA 22031-2713
Phone (703) 560-6686
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0401003206 | Other | VA | STATE PRACTICE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401003206 | VA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1548481237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3318 MANTUA DRIVE",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220312713",
"telephone_number": "703-560-6686",
"fax_number": "703-560-6812"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5827 COLUMBIA PIKE",
"address_2": "SUITE 405",
"city": "FALLS CHURCH",
"state": "VA",
"postal_code": "22041",
"telephone_number": "703-820-7170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROTMAN",
"first_name": "SANFORD",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-01",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "VA",
"license": "0401003206",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE PRACTICE LICENSE",
"identifier": "0401003206",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Falls Church, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.