Individual provider Active NPI

Fernando Apolinario Maravi, DDS

  • Dentist
  • Arlington, VA
National Provider Identifier
1790772648
Registry record updated Apr 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
045608-1 Issued in NY
Practice address
900 17TH St S
Arlington, VA 22202-2602
Phone
(610) 299-1673
NPI assigned
Oct 5, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 045608-1 NY Primary

Addresses

Primary practice location

900 17TH St S
Arlington, VA 22202-2602

Mailing address

900 17TH St S
Arlington, VA 22202-2602
Phone (610) 299-1673

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
045608-1NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303171200000",
    "number": "1790772648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 17TH ST S",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222022602",
            "telephone_number": "610-299-1673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 17TH ST S",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222022602",
            "telephone_number": "610-299-1673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARAVI",
        "first_name": "FERNANDO",
        "middle_name": "APOLINARIO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2011-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "045608-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2011; 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.