The Tooth Doc LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

THE TOOTH DOC LLC

Doing business as

The tooth Doc

Practice address

1911 Ballenger Ave
Alexandria, VA 22314-6819

Phone

(703) 299-1200

Fax

(703) 299-1222

NPI assigned

Nov 21, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Afsaneh S Shahidi, DDSNPI 1831573575

Title

Owner

Phone

(703) 483-0857

Specialties & licenses 1

Addresses

Other names 1

• The tooth Doc Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Afsaneh Samatha Shahidi, DDS

  • Dentist
  • Woodbridge, VA
  • NPI 1831573575

  General Practice

  NPD Authorized official

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

{
    "created_epoch": "1700524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700524800000",
    "number": "1740055680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1911 BALLENGER AVE",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223146819",
            "telephone_number": "703-299-1200",
            "fax_number": "703-299-1222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 BALLENGER AVE",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223146819",
            "telephone_number": "703-299-1200",
            "fax_number": "703-299-1222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE TOOTH DOC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-21",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A",
        "authorized_official_last_name": "SHAHIDI",
        "authorized_official_first_name": "AFSANEH",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-483-0857",
        "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": "The tooth Doc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Alexandria, VA
• Providers in Alexandria, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2023; 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.