McLean Oral & Maxillofacial Surgery

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

3844 Issued in VA

Legal business name

MCLEAN ORAL & MAXILLOFACIAL SURGERY

Practice address

1515 Chain Bridge Rd
Suite 206
MC Lean, VA 22101-4451

Phone

(703) 893-8800

Fax

(703) 893-8845

NPI assigned

Aug 8, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Eric A Foretich, D.D.S., M.A.NPI 1972720654

Title

Owner

Phone

(703) 893-8800

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Eric A Foretich, D.D.S., M.A.

  • Oral and Maxillofacial Surgery (Dentist)
  • McLean, VA
  • NPI 1972720654
  NPD (past) Authorized official

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

{
    "created_epoch": "1186531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186531200000",
    "number": "1760673214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10440 NEW ASCOT DR",
            "city": "GREAT FALLS",
            "state": "VA",
            "postal_code": "220663421",
            "telephone_number": "703-893-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 CHAIN BRIDGE RD",
            "address_2": "SUITE 206",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221014451",
            "telephone_number": "703-893-8800",
            "fax_number": "703-893-8845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCLEAN ORAL & MAXILLOFACIAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-08",
        "last_updated": "2007-08-08",
        "status": "A",
        "authorized_official_last_name": "FORETICH",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-893-8800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S., M.A."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "VA",
            "license": "3844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• McLean Dental Loft PLLC
• McLean Dermatology and Skincare Center
• McLean Medical Center and Urgent Care LLC
• McLean Neuropsychiatric Treatment Center LLC
• McLean Optometry, LLC
• McLean Pharmacy Inc
• McLean Psychiatric Services LLC
• McLean Rhinoplasty, ENT & Sinus PLLC
• McLean Tysons Orthopedic Surgery Center, LLC
• Darius McLean, PA-C

• Exclusive Provider Organization in MC Lean, VA
• Providers in MC Lean, VA by specialty
• Exclusive Provider Organization in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2007; 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.