NPIMap

Organization Active NPI

Dynamic Dental PC

  • General Practice Dentistry
  • Falls Church, VA
National Provider Identifier
1750669883
Registry record updated Jul 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401412386 Issued in VA
Legal business name
DYNAMIC DENTAL PC
Practice address
159 Hillwood Ave
Falls Church, VA 22046-2913
Phone
(703) 531-0010
Fax
(703) 531-1330
NPI assigned
Jul 22, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2011

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

Authorized official

Name
Farida G Khattak, DDS
Title
Owner/Dentist
Phone
(703) 531-0010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 0401412386 VA Primary

Addresses

Primary practice location

159 Hillwood Ave
Falls Church, VA 22046-2913

Mailing address

159 Hillwood Ave
Falls Church, VA 22046-2913
Phone (703) 531-0010

Other identifiers 1

IdentifierTypeStateIssuer
1841430873OtherVANPI

Other names 1

  • Dynamic Family Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

159 Hillwood Ave
Falls Church, VA 22046
Phone (703) 531-0010

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1311292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311292800000",
    "number": "1750669883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 HILLWOOD AVE",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220462913",
            "telephone_number": "703-531-0010",
            "fax_number": "703-531-1330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 HILLWOOD AVE",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220462913",
            "telephone_number": "703-531-0010",
            "fax_number": "703-531-1330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-22",
        "last_updated": "2011-07-22",
        "status": "A",
        "authorized_official_last_name": "KHATTAK",
        "authorized_official_first_name": "FARIDA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "703-531-0010",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401412386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1841430873",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dynamic Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Falls Church, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2011; 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.