NPIMap

Organization Active NPI

Richard J. Dellork, DDS

  • Endodontics
  • Vienna, VA
National Provider Identifier
1689865578
Registry record updated Aug 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
6478 Issued in VA
Legal business name
RICHARD J. DELLORK, DDS
Practice address
124 Park St SE
Suite 205
Vienna, VA 22180-4654
Phone
(703) 281-5522
NPI assigned
Aug 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2007

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

Authorized official

Name
Richard J Dellork, DDSNPI 1295758134
Title
Sole Proprietor
Phone
(703) 281-5522

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X 6478 VA Primary

Addresses

Primary practice location

124 Park St SE
Suite 205
Vienna, VA 22180-4654

Mailing address

124 Park St SE
Suite 205
Vienna, VA 22180-4654

National Provider Directory

National Provider Directory

Locations

124 Park St SE
Ste 205
Vienna, VA 22180
Phone (703) 281-5522

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": "1186358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186358400000",
    "number": "1689865578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 PARK ST SE",
            "address_2": "SUITE 205",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221804654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 PARK ST SE",
            "address_2": "SUITE 205",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221804654",
            "telephone_number": "703-281-5522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD J. DELLORK, DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-06",
        "last_updated": "2007-08-06",
        "status": "A",
        "authorized_official_last_name": "DELLORK",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "703-281-5522",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "VA",
            "license": "6478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 6, 2007; 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.