Organization Active NPI

Impact Dental Care, PLLC

  • Dentist
  • Lorton, VA
National Provider Identifier
1851960884
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
IMPACT DENTAL CARE, PLLC
Practice address
9439 Lorton Market St
Lorton, VA 22079-1963
Phone
(703) 952-6600
Fax
(703) 952-6364
NPI assigned
Jun 23, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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

Authorized official

Name
Harpreet Kaur
Title
Manager
Phone
(703) 952-6600

Specialties & licenses 1

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

Addresses

Primary practice location

9439 Lorton Market St
Lorton, VA 22079-1963

Mailing address

9439 Lorton Market St
Lorton, VA 22079-1963

National Provider Directory

National Provider Directory

Locations

9439 Lorton Market St
Lorton, VA 22079
Phone (703) 372-2728

Practitioners & affiliated clinicians

Practitioners 1

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": "1624406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624406400000",
    "number": "1851960884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9439 LORTON MARKET ST",
            "city": "LORTON",
            "state": "VA",
            "postal_code": "220791963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9439 LORTON MARKET ST",
            "city": "LORTON",
            "state": "VA",
            "postal_code": "220791963",
            "telephone_number": "703-952-6600",
            "fax_number": "703-952-6364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT DENTAL CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-23",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A",
        "authorized_official_last_name": "KAUR",
        "authorized_official_first_name": "HARPREET",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "703-952-6600"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lorton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; 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.