Individual provider Active NPI

Gregory L Lavecchia, D.M.D.

  • General Practice Dentistry
  • Arlington, VA
National Provider Identifier
1568574648
Registry record updated Oct 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401410609 Issued in VA
Practice address
1515 Wilson Blvd.
Suite 103
Arlington, VA 22209
Phone
(703) 528-3336
Fax
(703) 524-2206
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2012

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 0401410609 VA Primary

Addresses

Primary practice location

1515 Wilson Blvd.
Suite 103
Arlington, VA 22209

Mailing address

1515 Wilson Blvd.
Suite 103
Arlington, VA 22209
Phone (703) 528-3336

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20160210002593 DC Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 6305140427

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349740800000",
    "number": "1568574648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 WILSON BLVD.",
            "address_2": "SUITE 103",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "22209",
            "telephone_number": "703-528-3336",
            "fax_number": "703-524-2206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 WILSON BLVD.",
            "address_2": "SUITE 103",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "22209",
            "telephone_number": "703-528-3336",
            "fax_number": "703-524-2206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVECCHIA",
        "first_name": "GREGORY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2012-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401410609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, VA

Sources for this page

Verify at the official NPI Registry.