NPIMap

Gustavo Manuel Arocha Jr., D.D.S

Individual provider Active NPI General Practice Dentistry · Woodbridge, VA

NPI 1609308683 · NPPES record last updated Aug 6, 2018

Key facts

NPI
1609308683
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
0401416103 (VA)
Practice address
4379 Ridgewood Center Dr Ste 102
Woodbridge, VA 22192
Phone
(703) 680-7950
NPI assigned
Mar 30, 2017
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 25, 2023 through Apr 25, 2027

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Amores Dental Care PA Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 0401416103 VA Yes

Addresses

Primary practice location

4379 Ridgewood Center Dr Ste 102
Woodbridge, VA 22192

Mailing address

4379 Ridgewood Center Dr Ste 102
Woodbridge, VA 22192-8323
Phone (703) 680-7950

Other practice location 1

12165 Elm St
Princess Anne, MD 21853-1358
Phone (410) 651-5151

Other providers in Woodbridge, VA

All providers in Woodbridge, VA · General Practice Dentistry in Virginia

Sources for this page

Verify at the official NPI Registry.