Kenneth Qiu, M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

401410740 Issued in VA

Practice address

1110 Elden St Ste E108
Herndon, VA 20170-5529

Phone

(703) 318-7200

Fax

(703) 318-8668

NPI assigned

Mar 26, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Dental Center of Herndon

  • General Practice Dentistry
  • Herndon, VA
  • NPI 1457608986
  NPD (past) Authorized official

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891813358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 ELDEN ST STE E108",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201705529",
            "telephone_number": "703-318-7200",
            "fax_number": "703-318-8668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 ELDEN ST STE E108",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201705529",
            "telephone_number": "703-318-7200",
            "fax_number": "703-318-8668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QIU",
        "first_name": "KENNETH",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "401102428",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "401410257",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "401410740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prosperity Eating Disorder and Wellness
• Provision Care LLC
• Donald Tyler Pubins
• Pure Movement Chiropractic, PLLC
• Melissa Marie Purvis
• Quality Chiropractic & Rehab
• Ernest N Quaye, M.D.
• Jay Brian Queen, DDS
• Della Query, MD
• Quest Home Care LLC

• General Practice Dentistry in Herndon, VA
• Providers in Herndon, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.