Patrick J Dolan, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

0401006509 Issued in VA

Practice address

10530 Rosehaven St
Suite 111
Fairfax, VA 22030-2840

Phone

(703) 385-5777

Fax

(703) 591-5386

NPI assigned

Jul 26, 2006

Last updated

Feb 19, 2009By the provider in NPPES

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 1, 2014 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fairfax Oral and Maxillofacial Surgery PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Fairfax, VA
  • NPI 1710907134
  NPD (past)

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235001600000",
    "number": "1760406805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10530 ROSEHAVEN ST",
            "address_2": "SUITE 111",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302840",
            "telephone_number": "703-385-5777",
            "fax_number": "703-591-5386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10530 ROSEHAVEN ST",
            "address_2": "SUITE 111",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302840",
            "telephone_number": "703-385-5777",
            "fax_number": "703-591-5386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLAN",
        "first_name": "PATRICK",
        "middle_name": "J",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2009-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "VA",
            "license": "0401006509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Virginia Doherty
• Naveen Doki, M.D
• Timothy Dokken, MPT
• Angela Dolan
• Lindsay Dolan
• Elissa Dolina, PSY.D.
• Taylor Dollins, BCBA
• Mark Christian Domanski, M.D.
• Domingo Suatengco, MD, PC
• Melanie Giselle Dominguez Felix

• Oral and Maxillofacial Surgery (Dentist) in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.