NPIMap

Organization Active NPI

Teruaki Kodama, M.D., L.L.C.

  • Surgery Physician
  • Fairfax, VA
National Provider Identifier
1720285893
Registry record updated Dec 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
0101048550 Issued in VA
Legal business name
TERUAKI KODAMA, M.D., L.L.C.
Practice address
8316 Arlington Blvd
Suite 410
Fairfax, VA 22031-5207
Phone
(703) 573-6985
Fax
(703) 573-7154
NPI assigned
Jun 30, 2007
Last updated
Dec 20, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2007

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

Authorized official

Name
Dr. Teruaki Kodama, M.D.
Title
President
Phone
(703) 573-6985

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 0101048550 VA Primary

Addresses

Primary practice location

8316 Arlington Blvd
Suite 410
Fairfax, VA 22031-5207

Mailing address

8316 Arlington Blvd
Suite 410
Fairfax, VA 22031-5207
Phone (703) 573-6985

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1183161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198108800000",
    "number": "1720285893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8316 ARLINGTON BLVD",
            "address_2": "SUITE 410",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220315207",
            "telephone_number": "703-573-6985",
            "fax_number": "703-573-7154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8316 ARLINGTON BLVD",
            "address_2": "SUITE 410",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220315207",
            "telephone_number": "703-573-6985",
            "fax_number": "703-573-7154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERUAKI KODAMA, M.D., L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-30",
        "last_updated": "2007-12-20",
        "status": "A",
        "authorized_official_last_name": "KODAMA",
        "authorized_official_first_name": "TERUAKI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-573-6985",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101048550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2007; 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.