NPIMap

Organization Active NPI

Tenleytown Dental, PLLC

  • General Practice Dentistry
  • Washington, DC
National Provider Identifier
1710650627
Registry record updated Jul 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
TENLEYTOWN DENTAL, PLLC
Doing business as
District Smiles
Practice address
4000 Albemarle St NW Ste 203
Washington, DC 20016-1851
Phone
(202) 363-4361
NPI assigned
Jul 27, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2021

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

Authorized official

Name
Dr. Aliya Badrudin Kassam, DDS
Title
Owner
Phone
(281) 935-7394

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

4000 Albemarle St NW Ste 203
Washington, DC 20016-1851

Mailing address

4000 Albemarle St NW Ste 203
Washington, DC 20016-1851
Phone (202) 363-4361

Other names 1

  • District Smiles Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1627344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627516800000",
    "number": "1710650627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 ALBEMARLE ST NW STE 203",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200161851",
            "telephone_number": "202-363-4361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 ALBEMARLE ST NW STE 203",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200161851",
            "telephone_number": "202-363-4361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENLEYTOWN DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-27",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A",
        "authorized_official_last_name": "KASSAM",
        "authorized_official_first_name": "ALIYA",
        "authorized_official_middle_name": "BADRUDIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-935-7394",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "District Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2021; 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.