Organization Active NPI

Paul W Conrad DDS PC

  • General Practice Dentistry
  • Dumfries, VA
National Provider Identifier
1720148653
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
PAUL W CONRAD DDS PC
Practice address
16150 Country Club Drive
Dumfries, VA 22025
Phone
(703) 670-4838
Fax
(703) 670-7876
NPI assigned
Dec 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2008

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

Authorized official

Name
Wendy Jayne Mueller
Title
Front Office Manager
Phone
(703) 670-4838

Specialties & licenses 1

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

Addresses

Primary practice location

16150 Country Club Drive
Dumfries, VA 22025

Mailing address

16150 Country Club Drive
Dumfries, VA 22025
Phone (703) 670-4838

National Provider Directory

National Provider Directory

Locations

16150 Country Club Dr
Dumfries, VA 22025
Phone (703) 670-4838

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": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1720148653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16150 COUNTRY CLUB DRIVE",
            "city": "DUMFRIES",
            "state": "VA",
            "postal_code": "22025",
            "telephone_number": "703-670-4838",
            "fax_number": "703-670-7876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16150 COUNTRY CLUB DRIVE",
            "city": "DUMFRIES",
            "state": "VA",
            "postal_code": "22025",
            "telephone_number": "703-670-4838",
            "fax_number": "703-670-7876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL W CONRAD DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "MUELLER",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "JAYNE",
        "authorized_official_title_or_position": "FRONT OFFICE MANAGER",
        "authorized_official_telephone_number": "703-670-4838"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dumfries, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; 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.