Northern Virginia Center

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

0438000163 Issued in VA

Legal business name

NORTHERN VIRGINIA CENTER

Practice address

4211 Fairfax Corner East Ave
Suite # 235
Fairfax, VA 22030

Phone

(703) 449-8888

Fax

(703) 449-9888

NPI assigned

Oct 16, 2006

Organization subpart

No

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

Authorized official

Name

Miss Brenda Lee Picente

Title

Practice Manager

Phone

(703) 449-8888

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306281600000",
    "number": "1639259773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4211 FAIRFAX CORNER EAST AVE",
            "address_2": "SUITE # 235",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "22030",
            "telephone_number": "703-449-8888",
            "fax_number": "703-449-9888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 FAIRFAX CORNER EAST AVE",
            "address_2": "SUITE # 235",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "22030",
            "telephone_number": "703-449-8888",
            "fax_number": "703-449-9888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN VIRGINIA CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-16",
        "last_updated": "2011-05-25",
        "status": "A",
        "authorized_official_last_name": "PICENTE",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "703-449-8888",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401410440",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "VA",
            "license": "0438000163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• North American Partners in Anesthesia (Virginia), LLC
• North American Partners in Anesthesia Florida LLC
• John M North, M.D.
• Northern VA Home Healthcare LLC
• Northern Virginia Cardiology Associates, PC
• Northern Virginia Counseling Services Inc.
• Northern Virginia Endocrinologists Inc
• Northern Virginia Endocrinologists Inc
• Northern Virginia Endocrinologists Inc
• Northern Virginia Endodontic Solutions

• Oral and Maxillofacial Surgery (Dentist) in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 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.