Advanced Dental Anesthesia PLLC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

FI5268405 Issued in VA

Legal business name

ADVANCED DENTAL ANESTHESIA PLLC

Practice address

10611 Braddock Rd
Fairfax, VA 22032-2201

Phone

(202) 265-0805

NPI assigned

Aug 22, 2018

Last updated

Aug 22, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Reza Izadi, DONPI 1750598470

Title

Owner

Phone

(202) 265-0508

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Reza Izadi, D,O.

  • Anesthesiology Physician
  • Washington, DC
  • NPI 1750598470
  NPD Authorized official

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

{
    "created_epoch": "1534896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534896000000",
    "number": "1609357235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2776 S ARLINGTON MILL DR # 121",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222063402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10611 BRADDOCK RD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220322201",
            "telephone_number": "202-265-0805"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 Hobart St NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200092907",
            "country_code": "US",
            "telephone_number": "202-265-0508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ADVANCED DENTAL ANESTHESIA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-22",
        "last_updated": "2018-08-22",
        "status": "A",
        "authorized_official_last_name": "IZADI",
        "authorized_official_first_name": "REZA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "202-265-0508",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": "FI5268405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Leigh Adler, PH.D.
• Ebenezer Adufro
• Advance Medical Gi PC
• Advanced Audiology Group, Inc.
• Advanced Cosmetic Dentistry of Nova
• Advanced Hearing Services
• Advanced Internal Medicine, Inc.
• Advanced Medical and Professional Solutions, Inc. (Ace Rehab)
• Advanced Preventive Diagnostics, Inc
• Advanced Spine and Pain PLLC

• Anesthesiology Physician in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Anesthesiology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2018; 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.