Individual provider Active NPI

Ahmed Saadulla, DDS

  • General Practice Dentistry
  • McLean, VA
National Provider Identifier
1780036871
Registry record updated Jan 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
16561 Issued in MD
Practice address
8200 Greensboro Dr Ste 1002
MC Lean, VA 22102-3857
Phone
(703) 734-0515
Fax
(703) 734-5751
NPI assigned
Jul 12, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 16561 MD Primary

Addresses

Primary practice location

8200 Greensboro Dr Ste 1002
MC Lean, VA 22102-3857

Mailing address

4668 Carisbrooke LN
Fairfax, VA 22030-6115
Phone (703) 981-0695

Other practice location 1

1 Brookdale Plz
Brooklyn, NY 11212-3139
Phone (718) 240-6282

Other practice location 2

8316 Arlington Blvd Ste 226
Fairfax, VA 22031-5216
Phone (703) 560-6301

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

LicenseStateTypeSpecialty
16561MDMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
James T. Planicka, DDS, PC General Practice Past Accepting new patients
Brenda J Young DDS & Marjun Ayati DDS PC Past Accepting new patients
Hutchison & Gorman LLC General Practice Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1468281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1780036871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4668 CARISBROOKE LN",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306115",
            "telephone_number": "703-981-0695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 GREENSBORO DR STE 1002",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221023857",
            "telephone_number": "703-734-0515",
            "fax_number": "703-734-5751"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Brookdale Plz",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112123139",
            "country_code": "US",
            "telephone_number": "718-240-6282",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8316 Arlington Blvd Ste 226",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220315216",
            "country_code": "US",
            "telephone_number": "703-560-6301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAADULLA",
        "first_name": "AHMED",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-12",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "16561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McLean, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2020; 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.