Individual provider Active NPI

Payam Amirsayafi

  • Pediatric Dentistry
  • Stafford, VA
National Provider Identifier
1881968204
Registry record updated Feb 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
0401413323 Issued in VA
Practice address
1003 Garrisonville Rd
Stafford, VA 22556-1843
Phone
(540) 318-5577
Fax
(540) 369-6250
NPI assigned
Mar 2, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 0401413323 VA Primary

Addresses

Primary practice location

1003 Garrisonville Rd
Stafford, VA 22556-1843

Mailing address

1003 Garrisonville Rd
Stafford, VA 22556-1843
Phone (540) 318-5577

Other practice location 1

4100 Quarles Ct
Harrisonburg, VA 22801-8797
Phone (540) 432-0609

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
0401413323VAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Dental Group PLLC Pediatric Dentistry Past Accepting new patients
Massanutten Dental Team and Oral Surgery Past Accepting new patients
Red Apple Pediatric Dental Team Pediatric Dentistry PastSince Feb 23, 2020 Accepting new patients
Mountain View Dental Team Pediatric Dentistry Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1330646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549411200000",
    "number": "1881968204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 GARRISONVILLE RD",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225561843",
            "telephone_number": "540-318-5577",
            "fax_number": "540-369-6250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 GARRISONVILLE RD",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225561843",
            "telephone_number": "540-318-5577",
            "fax_number": "540-369-6250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4100 Quarles Ct",
            "address_purpose": "LOCATION",
            "city": "Harrisonburg",
            "state": "VA",
            "postal_code": "228018797",
            "country_code": "US",
            "telephone_number": "540-432-0609",
            "fax_number": "540-432-9097",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMIRSAYAFI",
        "first_name": "PAYAM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-02",
        "last_updated": "2019-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "VA",
            "license": "0401413323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stafford, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2019; 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.