Individual provider Active NPI

Mary Jane Catherine Korrigan, RDH

  • Dental Hygienist
  • Reston, VA
National Provider Identifier
1730252156
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
0402004555 Issued in VA
Practice address
1712 Clubhouse Rd
Suite 106
Reston, VA 20190
Phone
(703) 471-6600
NPI assigned
Nov 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 0402004555 VA Primary

Addresses

Primary practice location

1712 Clubhouse Rd
Suite 106
Reston, VA 20190

Mailing address

43925 Felicity Place
Ashburn, VA 20147
Phone (703) 729-3988

Other names 1

  • Miss Mary Jane Catherine Oleary Other name

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

LicenseStateTypeSpecialty
0402004555VAMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Zacko & Shatluch LTD Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730252156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43925 FELICITY PLACE",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "20147",
            "telephone_number": "703-729-3988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1712 CLUBHOUSE RD",
            "address_2": "SUITE 106",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "20190",
            "telephone_number": "703-471-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORRIGAN",
        "first_name": "MARY JANE",
        "middle_name": "CATHERINE",
        "name_prefix": "Mrs.",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "VA",
            "license": "0402004555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY JANE",
            "last_name": "OLEARY",
            "middle_name": "CATHERINE",
            "prefix": "MISS",
            "credential": "RDH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Reston, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.