GD VA Gda PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

GD VA GDA PLLC

Practice address

1600 Tysons Blvd Ste 120
MC Lean, VA 22102-4882

Phone

(703) 527-1020

NPI assigned

Mar 17, 2023

Organization subpart

No

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

Authorized official

Name

Chad Hendricks

Title

Credentialing

Phone

(612) 859-0444

Specialties & licenses 2

Addresses

Other names 1

• Galleria Dental Aesthetics Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chong Lee, D.D.S

  • General Practice Dentistry
  • McLean, VA
  • NPI 1598975070
  NPD (past)

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

{
    "created_epoch": "1679011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688515200000",
    "number": "1699477463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 TYSONS BLVD STE 120",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221024882",
            "telephone_number": "703-448-1020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 TYSONS BLVD STE 120",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221024882",
            "telephone_number": "703-527-1020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GD VA GDA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-17",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A",
        "authorized_official_last_name": "HENDRICKS",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "612-859-0444"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Galleria Dental Aesthetics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gary J. Soverow, MD, PC
• Susan Beardsley Gatsos, LPC
• Nordine Gaugau, M.D.
• Mandeep Grewal Gauthier, M.D.
• Lillian Gavrilovich, M.D.
• Joerissa Gearlds, PA-C
• Abraham Belay Gebremariam, PHARMD
• Gelber Psychiatric Associates
• Jason Andrew Gendell, M.D.
• Geo Healthcare LLC

• General Practice Dentistry in MC Lean, VA
• Providers in MC Lean, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2023; 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.