NPIMap

Organization Active NPI

Dental Center @ Lake Ridge

  • Clinic/Center
  • Woodbridge, VA
National Provider Identifier
1801242466
Registry record updated May 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
0401410245 Issued in VA
Legal business name
DENTAL CENTER @ LAKE RIDGE
Practice address
12764 Darby Brook CT
Woodbridge, VA 22192-2486
Phone
(703) 499-8888
NPI assigned
May 12, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2016

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

Authorized official

Name
Dr. Thao Doan, DDSNPI 1215915186
Title
Owner
Phone
(703) 499-8888

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 0401410245 VA Primary

Addresses

Primary practice location

12764 Darby Brook CT
Woodbridge, VA 22192-2486

Mailing address

12764 Darby Brook CT
Woodbridge, VA 22192-2486
Phone (703) 499-8888

National Provider Directory

National Provider Directory

Locations

12764 Darby Brook Ct
Woodbridge, VA 22192
Phone (703) 499-8888

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1463011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463011200000",
    "number": "1801242466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12764 DARBY BROOK CT",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221922486",
            "telephone_number": "703-499-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12764 DARBY BROOK CT",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221922486",
            "telephone_number": "703-499-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL CENTER @ LAKE RIDGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-12",
        "last_updated": "2016-05-12",
        "status": "A",
        "authorized_official_last_name": "DOAN",
        "authorized_official_first_name": "THAO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-499-8888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "VA",
            "license": "0401410245",
            "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 May 12, 2016; 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.