DRS McIlveen & Freedman PC

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

Organization subpart

No

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

Authorized official

Name

Dr. Lezley P McIlveen, DDS MS

Title

President Dentist

Phone

(703) 689-3900

Specialties & licenses 3

Addresses

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": []
}

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• All providers in Herndon, VA
• Pediatric Dentistry in Virginia

• 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.