Active NPI
Tetyana McCain, DDS
- Pediatric Dentistry
- Ashburn, VA
National Provider Identifier
1861853798
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 0445000304
- Practice address
- 42976 Nashua St
Ashburn, VA 20147 - Phone
- (571) 439-6795
- NPI assigned
- Mar 20, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 0401416023 | VA | |
| Pediatric Dentistry | 1223P0221X | 0445000304 | VA | Primary |
Addresses
Primary practice location
42976 Nashua St
Ashburn, VA 20147
Mailing address
42976 Nashua St
Ashburn, VA 20147-7452
Phone (571) 439-6795
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160614001790 | MI | Order and Referring Only - Other (Physician) | 3971894437 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401416023 | VA | MD | General Practice Dentistry |
| 0445000304 | VA | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1532131200000",
"number": "1861853798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "42976 NASHUA ST",
"city": "ASHBURN",
"state": "VA",
"postal_code": "201477452",
"telephone_number": "571-439-6795"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "42976 NASHUA ST",
"city": "ASHBURN",
"state": "VA",
"postal_code": "20147",
"telephone_number": "571-439-6795"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCAIN",
"first_name": "TETYANA",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-03-20",
"last_updated": "2018-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "VA",
"license": "0401416023",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "VA",
"license": "0445000304",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ashburn, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2018; 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.