Organization Active NPI

D&D Dental Manassass, PLLC

  • General Practice Dentistry
  • Manassas, VA
National Provider Identifier
1609358266
Registry record updated Aug 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401412527 Issued in VA
Legal business name
D&D DENTAL MANASSASS, PLLC
Practice address
8739 Plantation LN
Manassas, VA 20110-4506
Phone
(703) 368-0704
NPI assigned
Aug 30, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2018

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

Authorized official

Name
Dr. Angela Diaz, DDS
Title
Owner
Phone
(540) 710-0400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 0401412527 VA Primary

Addresses

Primary practice location

8739 Plantation LN
Manassas, VA 20110-4506

Mailing address

5830 Harrison Rd
Fredericksburg, VA 22407-4202
Phone (540) 710-0400

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1535587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535587200000",
    "number": "1609358266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5830 HARRISON RD",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224074202",
            "telephone_number": "540-710-0400",
            "fax_number": "540-710-2322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8739 PLANTATION LN",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104506",
            "telephone_number": "703-368-0704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D&D DENTAL MANASSASS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-30",
        "last_updated": "2018-08-30",
        "status": "A",
        "authorized_official_last_name": "DIAZ",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "540-710-0400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401412527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.