Bijan M Kooshki, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

0401008844 Issued in VA

Practice address

44345 Premier Plaza
Suite 220
Ashburn, VA 20147

Phone

(703) 729-9666

Fax

(703) 729-4722

NPI assigned

Jan 30, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Bright Smiles, DDS PC

  • General Practice Dentistry
  • Virginia Beach, VA
  • NPI 1194180760
  NPD (past)

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448064000000",
    "number": "1821134222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1444 KEMPSVILLE RD 101",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234647302",
            "telephone_number": "757-497-8611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44345 PREMIER PLAZA",
            "address_2": "SUITE 220",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "20147",
            "telephone_number": "703-729-9666",
            "fax_number": "703-729-4722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOOSHKI",
        "first_name": "BIJAN",
        "middle_name": "M",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2015-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "VA",
            "license": "0401008844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Lee Ridley Klucken, PHARMD
• Aimee Knecht, DPT
• Lacy Knight, PT
• Umesh V Kodu, MD
• Jonathon Konz, DDS
• Kayla Kopchak, BCBA, LBA
• Shaveta Kotwal, MD
• Kathleen Diane Kozma, PH.D.
• Kravitz Orthodonitcs
• Mary Barbara Krygiel, LAC

• Periodontics in Ashburn, VA
• Providers in Ashburn, VA by specialty
• Periodontics in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.