NPIMap

Organization Active NPI

Falls Church Modern Dentistry, PC

  • Dentist
  • Falls Church, VA
National Provider Identifier
1548728801
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
FALLS CHURCH MODERN DENTISTRY, PC
Practice address
1212 W Broad St
Falls Church, VA 22046-2116
Phone
(703) 519-6697
NPI assigned
Mar 6, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Authorized official

Name
Dr. Daniel Ribeiro, DMD
Title
Owner/DDS
Phone
(703) 519-6697

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

1212 W Broad St
Falls Church, VA 22046-2116

Mailing address

PO Box 920050
Dallas, TX 75392-0050

Other names 1

  • Falls Church Modern Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

1212 W Broad St
Falls Church, VA 22046
Phone (571) 599-9662

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1551830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724284800000",
    "number": "1548728801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 W BROAD ST",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220462116",
            "telephone_number": "703-519-6697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FALLS CHURCH MODERN DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-06",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A",
        "authorized_official_last_name": "RIBEIRO",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER/DDS",
        "authorized_official_telephone_number": "703-519-6697",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Falls Church Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Falls Church Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 22, 2024; 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.