NPIMap

Organization Active NPI

DRS McIlveen & Freedman PC

  • Pediatric Dentistry
  • Herndon, VA
National Provider Identifier
1821134636
Registry record updated Jul 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
0401-006884 Issued in VA
Legal business name
DRS MCILVEEN & FREEDMAN PC
Practice address
131 Elden St
Suite 130
Herndon, VA 20170
Phone
(703) 689-3900
Fax
(703) 689-3903
NPI assigned
Jan 29, 2007
Last updated
Jul 23, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2008

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

Authorized official

Name
Dr. Lezley P McIlveen, DDS MSNPI 1982665709
Title
President Dentist
Phone
(703) 689-3900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 0401-007357 VA
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 0401-006884 VA Primary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X 0401-006016 VA

Addresses

Primary practice location

131 Elden St
Suite 130
Herndon, VA 20170

Mailing address

131 Elden St
Suite 130
Herndon, VA 20170
Phone (703) 689-3900

National Provider Directory

National Provider Directory

Locations

131 Elden St
Ste 130
Herndon, VA 20170
Phone (703) 689-3900

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216771200000",
    "number": "1821134636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 ELDEN ST",
            "address_2": "SUITE 130",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "20170",
            "telephone_number": "703-689-3900",
            "fax_number": "703-689-3903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 ELDEN ST",
            "address_2": "SUITE 130",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "20170",
            "telephone_number": "703-689-3900",
            "fax_number": "703-689-3903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS MCILVEEN & FREEDMAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2008-07-23",
        "status": "A",
        "authorized_official_last_name": "MCILVEEN",
        "authorized_official_first_name": "LEZLEY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT DENTIST",
        "authorized_official_telephone_number": "703-689-3900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS MS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401-007357",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "VA",
            "license": "0401-006884",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "VA",
            "license": "0401-006016",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Herndon, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2008; 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.