Active NPI
Michael R Pichardo, DDS
- Endodontics
- Gainesville, VA
National Provider Identifier
1598801037
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 0401411746
- Practice address
- 7915 Lake Manassas Dr Ste 203
Gainesville, VA 20155-3259 - Phone
- (703) 753-4901
- NPI assigned
- Jan 30, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 19191 | TX | |
| Endodontics | 1223E0200X | 0401411746 | VA | Primary |
Addresses
Primary practice location
7915 Lake Manassas Dr Ste 203
Gainesville, VA 20155-3259
Mailing address
7915 Lake Manassas Dr
Suite 203
Gainesville, VA 20155-3258
Phone (703) 753-4901
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401411746 | VA | MD | Endodontist |
| 19191 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250812800000",
"number": "1598801037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7915 LAKE MANASSAS DR",
"address_2": "SUITE 203",
"city": "GAINESVILLE",
"state": "VA",
"postal_code": "201553258",
"telephone_number": "703-753-4901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7915 LAKE MANASSAS DR STE 203",
"city": "GAINESVILLE",
"state": "VA",
"postal_code": "201553259",
"telephone_number": "703-753-4901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PICHARDO",
"first_name": "MICHAEL",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-30",
"last_updated": "2009-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "TX",
"license": "19191",
"primary": false
},
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "VA",
"license": "0401411746",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gainesville, VA
- Pharmasutra PLLC
- David Randell Phelps, APRN
- Phoenix Counselinggroup and Play Therapycenter, PLLC
- Phoenix Family Counseling & Play Therapy Center, PLLC
- Faline Phucas Davenport
- Piedmont Professional Counseling
- Cecille M Pineda, PHARMD
- Jean Marie Pitt, CNA
- Mariano Andres Polack, DDS, MS
- Veronica Delatorre Porterfield, PA-C
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2009; 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.