Dental Associates of Northern Virginia PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

401005854 Issued in VA

Legal business name

DENTAL ASSOCIATES OF NORTHERN VIRGINIA PLLC

Doing business as

Dental Associates

Practice address

12011 Lee Jackson Hwy
Suite 105
Fairfax, VA 22033-3310

Phone

(703) 273-5354

Fax

(703) 273-8149

NPI assigned

Sep 6, 2011

Last updated

Sep 6, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stan Kinder

Title

Regional Vice President

Phone

(703) 298-1690

Specialties & licenses 1

Addresses

Other names 1

• Dental Associates Doing business as

Tax ID family

Dental Associates2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Dental Associates of Northern Virginia PLLC

  • General Practice Dentistry
  • Falls Church, VA
  • NPI 1518254432
  NPD tax ID

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

{
    "created_epoch": "1315267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315267200000",
    "number": "1881975738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12701 FAIR LAKES CIR",
            "address_2": "SUITE 500",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220334910",
            "telephone_number": "703-269-3150",
            "fax_number": "703-449-9865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12011 LEE JACKSON HWY",
            "address_2": "SUITE 105",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220333310",
            "telephone_number": "703-273-5354",
            "fax_number": "703-273-8149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL ASSOCIATES OF NORTHERN VIRGINIA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-06",
        "last_updated": "2011-09-06",
        "status": "A",
        "authorized_official_last_name": "KINDER",
        "authorized_official_first_name": "STAN",
        "authorized_official_title_or_position": "REGIONAL VICE PRESIDENT",
        "authorized_official_telephone_number": "703-298-1690"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "VA",
            "license": "401005854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• S Renee Dennis, NP
• Tosha Dennis
• Michelle Denny
• Dental Associates
• Dental Associates LTD (Dental Associates)
• Dental One Associates (Old Dominion) PLLC
• Dental One Associates (Woodson Square), LTD
• Dental Professionals of Virginia, P.C. (Poplar Tree Dental Care)
• Dental Services DDS, PC
• Dentists of Fair Oaks

• Dental Clinic/Center in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Dental Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2011; 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.