Active NPI
Eliana Lourdes Anderson, DDS
- General Practice Dentistry
- Woodbridge, VA
National Provider Identifier
1871755231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 0401413574
- Practice address
- 4379 Ridgewood Center Dr Ste 102
Woodbridge, VA 22192-8323 - Phone
- (703) 680-7950
- Fax
- (703) 680-7953
- NPI assigned
- Jun 26, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 0401413574 | VA | Primary |
Addresses
Primary practice location
4379 Ridgewood Center Dr Ste 102
Woodbridge, VA 22192-8323
Mailing address
15609 Wingspan CT
Woodbridge, VA 22193-1103
Phone (540) 318-9109
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- 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 |
|---|---|---|---|---|
| I20170919000298 | VA | Order and Referring Only - Dentist | 3072887835 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401413574 | VA | MD | General Practice Dentistry |
Interoperability endpoints
- eliana.cuellar@gpwchc.eclinicaldirectplus.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536796800000",
"number": "1871755231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15609 WINGSPAN CT",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221931103",
"telephone_number": "540-318-9109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4379 RIDGEWOOD CENTER DR STE 102",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221928323",
"telephone_number": "703-680-7950",
"fax_number": "703-680-7953"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "ELIANA",
"middle_name": "LOURDES",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-26",
"last_updated": "2018-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "VA",
"license": "0401413574",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodbridge, VA
- Anderson Dental Associates II PLLC (RenovaSmiles Woodbridge)
- Anderson Dental Associates III, PLLC
- Anderson Dental Associates IV (RenovaSmiles)
- Anderson-Khimani Center for Early Intervention and Autism Services
- Charles Anderson, PH.D.
- Maralize Hester Anderson, CCC-SLP
- Melissa Beth Anderson, LCSW, LSATP
- Renee Anderson, LMT
- Andolina Chiropractic & Rehab
- Andrew V. Kriegel, MD, LLC (AVK Plastic Surgery)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.