Active NPI
Maryann Kan, DDS
- Dentist
- Alexandria, VA
National Provider Identifier
1689728503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 7616
- Practice address
- 6389 Little River Tpke
Alexandria, VA 22312-5002 - Phone
- (703) 916-0955
- Fax
- (703) 916-0680
- NPI assigned
- Jan 22, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 7616 | VA | Primary |
Addresses
Primary practice location
6389 Little River Tpke
Alexandria, VA 22312-5002
Mailing address
6389 Little River Tpke
Alexandria, VA 22312-5002
Phone (703) 916-0955
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective May 2, 2016 through May 2, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7616 | VA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1689728503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6389 LITTLE RIVER TPKE",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223125002",
"telephone_number": "703-916-0955",
"fax_number": "703-916-0680"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6389 LITTLE RIVER TPKE",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223125002",
"telephone_number": "703-916-0955",
"fax_number": "703-916-0680"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAN",
"first_name": "MARYANN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VA",
"license": "7616",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.