Individual provider Active NPI

Borin Mak Yann, DDS

  • Dentist
  • Alexandria, VA
National Provider Identifier
1689723926
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401410442 Issued in VA
Practice address
6428 Landsdowne Centre
Alexandria, VA 22315-5003
Phone
(703) 550-2940
Fax
(703) 550-2943
NPI assigned
Jan 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401410442 VA Primary

Addresses

Primary practice location

6428 Landsdowne Centre
Alexandria, VA 22315-5003

Mailing address

6428 Landsdowne Centre
Alexandria, VA 22315-5003
Phone (703) 550-2940

Other practice location 1

7906 Andrus Rd Ste 17
Alexandria, VA 22306-3169
Phone (703) 682-8773

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0401410442VAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1689723926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6428 LANDSDOWNE CENTRE",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223155003",
            "telephone_number": "703-550-2940",
            "fax_number": "703-550-2943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6428 LANDSDOWNE CENTRE",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223155003",
            "telephone_number": "703-550-2940",
            "fax_number": "703-550-2943"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7906 Andrus Rd Ste 17",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223063169",
            "country_code": "US",
            "telephone_number": "703-682-8773",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YANN",
        "first_name": "BORIN",
        "middle_name": "MAK",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401410442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; 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.