Active NPI
Alan Elie Jureidini
- Periodontics
- Arlington, VA
National Provider Identifier
1750765061
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 0401414717
- Practice address
- 900 N Stuart St
Apt 1618
Arlington, VA 22203-4101 - Phone
- (347) 206-1552
- NPI assigned
- Jul 16, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 0401414717 | VA | Primary |
Addresses
Primary practice location
900 N Stuart St
Apt 1618
Arlington, VA 22203-4101
Mailing address
900 N Stuart St
Apt 1618
Arlington, VA 22203-4101
Phone (347) 206-1552
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0401414717 | VA | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437004800000",
"number": "1750765061",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 N STUART ST",
"address_2": "APT 1618",
"city": "ARLINGTON",
"state": "VA",
"postal_code": "222034101",
"telephone_number": "347-206-1552"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 N STUART ST",
"address_2": "APT 1618",
"city": "ARLINGTON",
"state": "VA",
"postal_code": "222034101",
"telephone_number": "347-206-1552"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUREIDINI",
"first_name": "ALAN",
"middle_name": "ELIE",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-07-16",
"last_updated": "2015-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "VA",
"license": "0401414717",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arlington, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.