Organization Active NPI

Jason F Favagehi DDS PC

  • Dentist
  • Arlington, VA
National Provider Identifier
1811040561
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401007352 Issued in VA
Legal business name
JASON F FAVAGEHI DDS PC
Practice address
1000 Wilson Blvd
Suite M745
Arlington, VA 22209
Phone
(703) 527-6453
Fax
(703) 527-8643
NPI assigned
Jan 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Jason Farr Favagehi, DDS
Title
Owner
Phone
(703) 356-1200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 0401007352 VA Primary

Addresses

Primary practice location

1000 Wilson Blvd
Suite M745
Arlington, VA 22209

Mailing address

1000 Wilson Blvd
Suite M745
Arlington, VA 22209
Phone (703) 527-6453

Other names 1

  • Rosslyn Dental Art Center Doing business as

National Provider Directory

National Provider Directory

Locations

1000 Wilson Blvd
Ste M745
Arlington, VA 22209
Phone (703) 527-6453

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811040561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 WILSON BLVD",
            "address_2": "SUITE M745",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "22209",
            "telephone_number": "703-527-6453",
            "fax_number": "703-527-8643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 WILSON BLVD",
            "address_2": "SUITE M745",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "22209",
            "telephone_number": "703-527-6453",
            "fax_number": "703-527-8643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASON F FAVAGEHI DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FAVAGEHI",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "FARR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-356-1200",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401007352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rosslyn Dental Art Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 22, 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.