NPIMap

Organization Active NPI

Tysons Dental Spa

  • Dental Clinic/Center
  • Vienna, VA
National Provider Identifier
1619696754
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
TYSONS DENTAL SPA
Practice address
8300 Boone Blvd Ste 140
Vienna, VA 22182-2626
Phone
(703) 714-7374
Fax
(703) 714-7376
NPI assigned
Aug 23, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

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

Authorized official

Name
Dr. Sylvie Lam, DDS
Title
Owner
Phone
(703) 714-7374

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

8300 Boone Blvd Ste 140
Vienna, VA 22182-2626

Mailing address

8300 Boone Blvd Ste 140
Vienna, VA 22182-2626
Phone (703) 714-7374

Other names 1

  • Tysons Dental Spa LLC Doing business as

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": "1661212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661212800000",
    "number": "1619696754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8300 BOONE BLVD STE 140",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822626",
            "telephone_number": "703-714-7374",
            "fax_number": "703-714-7376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 BOONE BLVD STE 140",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822626",
            "telephone_number": "703-714-7374",
            "fax_number": "703-714-7376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TYSONS DENTAL SPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-23",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-17",
        "status": "A",
        "authorized_official_last_name": "LAM",
        "authorized_official_first_name": "SYLVIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-714-7374",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tysons Dental Spa LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vienna, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; 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.