NPIMap

Organization Active NPI

Gary S Nelson DMD Inc

  • Dentist
  • Leesburg, VA
National Provider Identifier
1609983931
Registry record updated Jul 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401007110 Issued in VA
Legal business name
GARY S NELSON DMD INC
Practice address
21 Fort Evans Rd NE Ste E
Leesburg, VA 20176-4488
Phone
(703) 777-7307
Fax
(703) 777-7840
NPI assigned
Aug 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2011

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

Authorized official

Name
Gary S Nelson, DMD
Title
President
Phone
(703) 777-7307

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 0401007110 VA Primary

Addresses

Primary practice location

21 Fort Evans Rd NE Ste E
Leesburg, VA 20176-4488

Mailing address

21 Fort Evans Rd NE Ste E
Leesburg, VA 20176-4488
Phone (703) 777-7307

National Provider Directory

National Provider Directory

Locations

21 Fort Evans Rd NE
Ste E
Leesburg, VA 20176
Phone (703) 777-7307

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": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309478400000",
    "number": "1609983931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 FORT EVANS RD NE STE E",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201764488",
            "telephone_number": "703-777-7307",
            "fax_number": "703-777-7840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 FORT EVANS RD NE STE E",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201764488",
            "telephone_number": "703-777-7307",
            "fax_number": "703-777-7840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY S NELSON DMD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2011-07-01",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-777-7307",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401007110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2011; 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.