Individual provider Active NPI

Janis Ann Slezak, RDH

  • Dental Hygienist
  • Woodbridge, VA
National Provider Identifier
1780354415
Registry record updated Sep 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
0402206910 Issued in VA
Practice address
12140 Breckinridge LN
Woodbridge, VA 22192-6033
Phone
(571) 319-7621
NPI assigned
Sep 15, 2021
Last updated
Sep 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 0402206910 VA Primary

Addresses

Primary practice location

12140 Breckinridge LN
Woodbridge, VA 22192-6033

Mailing address

12140 Breckinridge LN
Woodbridge, VA 22192-6033
Phone (571) 319-7621

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
0402206910VAMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1631664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1780354415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12140 BRECKINRIDGE LN",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221926033",
            "telephone_number": "571-319-7621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12140 BRECKINRIDGE LN",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221926033",
            "telephone_number": "571-319-7621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLEZAK",
        "first_name": "JANIS",
        "middle_name": "ANN",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-15",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "VA",
            "license": "0402206910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2021; 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.