Active NPI
Chaitanya Krishna Dahagam, MD
- Surgery Physician
- Fairfax, VA
National Provider Identifier
1871774232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 0101251530
- Practice address
- 8819 Blue Royale LN
Fairfax, VA 22031-2150 - Phone
- (256) 457-7701
- NPI assigned
- Nov 14, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 0101251530 | VA | Primary |
Addresses
Primary practice location
8819 Blue Royale LN
Fairfax, VA 22031-2150
Mailing address
8819 Blue Royale LN
Fairfax, VA 22031-2150
Phone (256) 457-7701
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101251530 | VA | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1194998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1428537600000",
"number": "1871774232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8819 BLUE ROYALE LN",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220312150",
"telephone_number": "256-457-7701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8819 BLUE ROYALE LN",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220312150",
"telephone_number": "256-457-7701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAHAGAM",
"first_name": "CHAITANYA",
"middle_name": "KRISHNA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-11-14",
"last_updated": "2015-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "VA",
"license": "0101251530",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.