Mohammad Elkhateeb, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

14081 Issued in MD

Practice address

2230 Gallows Rd Ste 320
Vienna, VA 22027-1101

Phone

(703) 573-8664

NPI assigned

Jul 28, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Image Dental Care LLC

  • Dental Clinic/Center
  • Burtonsville, MD
  • NPI 1205686052
  NPD Authorized official

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

{
    "created_epoch": "1248739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252627200000",
    "number": "1700017589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 SHEFFIELD MANOR CT APT 203",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209047759",
            "telephone_number": "240-271-8482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 GALLOWS RD STE 320",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "220271101",
            "telephone_number": "703-573-8664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELKHATEEB",
        "first_name": "MOHAMMAD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-28",
        "last_updated": "2009-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401411889",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "14081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elevated Mindset Therapy, LLC
• Elite Care at Home of Northern Virginia LLC
• Elite Dermatology and Esthetics LLC
• Elite Home Health, LLC
• Elite Plastic Surgery LLC
• Elle Dental PC
• Gary Ellenbogen, D.D.S.
• Rebecca Elliott
• Kathryn Krueger Ellis, N.P.
• Mary Anne Ellis, JD,PSYD

• General Practice Dentistry in Vienna, VA
• Providers in Vienna, 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 Sep 11, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.