Brite Smile Dental Group PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

0401412648 Issued in VA

Legal business name

BRITE SMILE DENTAL GROUP PC

Practice address

8577 Sudley Rd Ste B
Manassas, VA 20110-3860

Phone

(703) 368-5885

Fax

(703) 368-1852

NPI assigned

Sep 23, 2015

Organization subpart

No

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

Authorized official

Name

Jaewon Yoon, D.M.D.

Title

President

Phone

(703) 368-5885

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Brite Smile Dental Doing business as

Tax ID family

Brite Smile Dental Group PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Brite Smile Dental Group PC

  • Dental Clinic/Center
  • Centreville, VA
  • NPI 1205260858
  NPD tax ID
• Brite Smile Dental Group, P.C.

  • Dental Clinic/Center
  • Ellicott City, MD
  • NPI 1942634571
  NPD tax ID

Locations

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

{
    "created_epoch": "1442966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442966400000",
    "number": "1740659598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8577 SUDLEY RD STE B",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201103860",
            "telephone_number": "703-368-5885",
            "fax_number": "703-368-1852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8577 SUDLEY RD STE B",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201103860",
            "telephone_number": "703-368-5885",
            "fax_number": "703-368-1852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRITE SMILE DENTAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-23",
        "last_updated": "2015-09-23",
        "status": "A",
        "authorized_official_last_name": "YOON",
        "authorized_official_first_name": "JAEWON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-368-5885",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "VA",
            "license": "0401412648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "026866600",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brite Smile Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brightcare
• Brighter Life Home Health Care, LLC
• Brightnest Home Health Care LLC
• Joseph Briglia, PMHNP-BC
• Bristow Optometry, LLC
• April Jae Brittain
• Stephanie Mae Karavatas Brizek, LPTA
• Rose Broberg
• Jennifer Lynn Brock, LPC
• Robin Elizabeth Brodie, M.D.

• Dental Clinic/Center in Manassas, VA
• Providers in Manassas, VA by specialty
• Dental Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2015; 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.