NPIMap

Individual provider Active NPI

Ibrahim Y Alhussain, D.M.D.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Vienna, VA
National Provider Identifier
1871645929
Registry record updated Jun 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
0401411559 Issued in VA
Practice address
1500 Cornerside Blvd
Suite 200
Vienna, VA 22182-2433
Phone
(703) 821-2222
Fax
(703) 821-2221
NPI assigned
Jan 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 0401411559 VA Primary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 13503 MD

Addresses

Primary practice location

1500 Cornerside Blvd
Suite 200
Vienna, VA 22182-2433

Mailing address

1500 Cornerside Blvd
Suite 200
Vienna, VA 22182-2433
Phone (703) 821-2222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
13503MDMDOrthodontics and Dentofacial Orthopedic Dentist
0401411559VAMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434931200000",
    "number": "1871645929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 CORNERSIDE BLVD",
            "address_2": "SUITE 200",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822433",
            "telephone_number": "703-821-2222",
            "fax_number": "703-821-2221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 CORNERSIDE BLVD",
            "address_2": "SUITE 200",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822433",
            "telephone_number": "703-821-2222",
            "fax_number": "703-821-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALHUSSAIN",
        "first_name": "IBRAHIM",
        "middle_name": "Y",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2015-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "VA",
            "license": "0401411559",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MD",
            "license": "13503",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vienna, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2015; 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.