Organization Active NPI

All Pro Dental Care

  • Health Maintenance Organization
  • Fairfax, VA
National Provider Identifier
1760811855
Registry record updated Nov 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
0401410151 Issued in VA
Legal business name
ALL PRO DENTAL CARE
Practice address
8500 Executive Park Ave
Suite 208
Fairfax, VA 22031-2225
Phone
(703) 663-8276
NPI assigned
Nov 8, 2013
Last updated
Nov 8, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2013

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

Authorized official

Name
Dr. Mai Koussa, DDS
Title
Dentist
Phone
(703) 663-8276

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X 0401410151 VA Primary

Addresses

Primary practice location

8500 Executive Park Ave
Suite 208
Fairfax, VA 22031-2225

Mailing address

8500 Executive Park Ave
Suite 208
Fairfax, VA 22031-2225
Phone (703) 663-8276

National Provider Directory

National Provider Directory

Locations

8500 Executive Park Ave
Ste 208
Fairfax, VA 22031
Phone (703) 400-3675

NPI Registry JSON

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

{
    "created_epoch": "1383868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383868800000",
    "number": "1760811855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8500 EXECUTIVE PARK AVE",
            "address_2": "SUITE 208",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220312225",
            "telephone_number": "703-663-8276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8500 EXECUTIVE PARK AVE",
            "address_2": "SUITE 208",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220312225",
            "telephone_number": "703-663-8276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALL PRO DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-08",
        "last_updated": "2013-11-08",
        "status": "A",
        "authorized_official_last_name": "KOUSSA",
        "authorized_official_first_name": "MAI",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "703-663-8276",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "VA",
            "license": "0401410151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2013; 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.