Damon Roozbehan, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

0401418522 Issued in VA

Practice address

8150 Leesburg Pike Ste 900
Vienna, VA 22182-7700

Phone

(703) 288-4700

NPI assigned

Jun 15, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Tysons Corner Advanced Dental Center PC

  • General Practice Dentistry
  • Vienna, VA
  • NPI 1356528327
  NPD (past)

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

{
    "created_epoch": "1686787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700092800000",
    "number": "1750065082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 N STERLING BLVD",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201642931",
            "telephone_number": "571-277-9884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8150 LEESBURG PIKE STE 900",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221827700",
            "telephone_number": "703-288-4700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "716 N Sterling Blvd",
            "address_purpose": "LOCATION",
            "city": "Sterling",
            "state": "VA",
            "postal_code": "201642931",
            "country_code": "US",
            "telephone_number": "571-277-9884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROOZBEHAN",
        "first_name": "DAMON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-15",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401418522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mayra B. Roldan, SLP-CCC
• Maria Isabella Ortega Roma, OD
• Allyson Romanow
• Julia Elizabeth Romero, RN, IBCLC
• Ronald M Rosenberg DDS Ms LTD
• Andrea C Rosales, MA, CCC-SLP
• Brooke Rose
• Ronald M Rosenberg, D.D.S.
• Anne C Ross, LCSW
• Carolyn 'Carlie' French Ross, L.C.S.W.

• Dentist in Vienna, VA
• Providers in Vienna, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.