Individual provider Active NPI

Kimberly A Silloway, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Fairfax, VA
National Provider Identifier
1790795466
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
0401007884 Issued in VA
Practice address
10530 Rosehaven St
Suite 111
Fairfax, VA 22030-2840
Phone
(703) 385-5777
Fax
(703) 591-5386
NPI assigned
Aug 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 0401007884 VA Primary

Addresses

Primary practice location

10530 Rosehaven St
Suite 111
Fairfax, VA 22030-2840

Mailing address

10530 Rosehaven St
Suite 111
Fairfax, VA 22030-2840
Phone (703) 385-5777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Apr 1, 2012 through Apr 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0401007884VAMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Fairfax Oral and Maxillofacial Surgery PC Oral and Maxillofacial Surgery Past Accepting new patients

Organizations & group practices 1

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": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790795466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10530 ROSEHAVEN ST",
            "address_2": "SUITE 111",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302840",
            "telephone_number": "703-385-5777",
            "fax_number": "703-591-5386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10530 ROSEHAVEN ST",
            "address_2": "SUITE 111",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302840",
            "telephone_number": "703-385-5777",
            "fax_number": "703-591-5386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SILLOWAY",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "VA",
            "license": "0401007884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.