Alyssa Hartman, DDS
Individual provider Active NPI Dentist · Arlington, VA
NPI 1679969653 · NPPES record last updated Nov 9, 2017
Key facts
- NPI
- 1679969653
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 0401414811 (VA)
- Practice address
- 1025 N Fillmore Street
Suite C
Arlington, VA 22201 - Phone
- (703) 243-4500
- Fax
- (703) 243-4100
- NPI assigned
- Apr 7, 2015
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150720002497 | VA | Order and Referring Only - Dentist |
3870806847 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401414811 | VA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elite Dental | Dentist | Past | Accepting new patients |
| Elite Dental | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 0401414811 | VA | Yes |
Addresses
Primary practice location
1025 N Fillmore Street
Suite C
Arlington, VA 22201
Mailing address
1025 N Fillmore Street
Suite C
Arlington, VA 22201
Phone (703) 243-4500
Other names
- Ms. Alyssa Werner
Other providers in Arlington, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 9, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.