Active NPI
Aws Altameemi
- General Practice Dentistry
- Stafford, VA
National Provider Identifier
1700368156
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 0401416174
- Practice address
- 392 Garrisonville Road 205
Stafford, VA 22554 - Phone
- (240) 200-4006
- NPI assigned
- Sep 2, 2018
- Last updated
- Sep 2, 2018
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 0401416174 | VA | Primary |
Addresses
Primary practice location
392 Garrisonville Road 205
Stafford, VA 22554
Mailing address
14701 River Walk Way Apt 396
Woodbridge, VA 22191
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0401416174 | VA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elle Dental PC | Current | Accepting new patients |
Locations
8296 Old Courthouse Rd
Ste A
Vienna, VA 22182
Phone (703) 848-8889
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535846400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535846400000",
"number": "1700368156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14701 RIVER WALK WAY APT 396",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "22191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "392 GARRISONVILLE ROAD 205",
"city": "STAFFORD",
"state": "VA",
"postal_code": "22554",
"telephone_number": "240-200-4006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALTAMEEMI",
"first_name": "AWS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-09-02",
"last_updated": "2018-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "VA",
"license": "0401416174",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Stafford, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.