Individual provider Active NPI

Brian J Nalls, D.M.D.

  • Endodontics
  • Vienna, VA
National Provider Identifier
1619215670
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
0401415205 Issued in VA
Practice address
8150 Leesburg Pike Ste 200
Vienna, VA 22182-2714
Phone
(703) 288-3299
Fax
(703) 288-3297
NPI assigned
Jan 26, 2013
Sex
Male
Sole proprietor
No

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20160208000867 PA Order and Referring Only - DentistPractitioner - Dentist 0547564866

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0401415205VAMDEndodontist

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 0401415205 VA Primary

Addresses

NPPES NPI Registry

Primary practice location

8150 Leesburg Pike Ste 200
Vienna, VA 22182-2714

Mailing address

8150 Leesburg Pike Ste 200
Vienna, VA 22182-2714
Phone (703) 288-3299

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 29, 2021.

{
    "created_epoch": "1359158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1619215670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8150 LEESBURG PIKE STE 200",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822714",
            "telephone_number": "703-288-3299",
            "fax_number": "703-288-3297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8150 LEESBURG PIKE STE 200",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822714",
            "telephone_number": "703-288-3299",
            "fax_number": "703-288-3297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NALLS",
        "first_name": "BRIAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-26",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "VA",
            "license": "0401415205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vienna, VA

Sources for this page

Verify at the official NPI Registry.