Gregory M Ivy DDS and Cecilia Ykeda DDS PLC

Primary specialty

DentistTaxonomy code 122300000X

License

0401410477 Issued in VA

Legal business name

GREGORY M IVY DDS AND CECILIA YKEDA DDS PLC

Practice address

8342 Traford Lane
Springfield, VA 22152-1638

Phone

(703) 644-5955

Fax

(703) 644-1337

NPI assigned

Nov 15, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Cecilia Ykeda, DDS

Title

Dentist

Phone

(703) 644-5955

Specialties & licenses 1

Addresses

Tax ID family

Gregory M Ivy DDS and Cecilia Ykeda DDS PLC2 organizations share this tax ID, including this one

Locations

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891867503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8342 TRAFORD LANE",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221521638",
            "telephone_number": "703-644-5955",
            "fax_number": "703-644-1337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8342 TRAFORD LANE",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221521638",
            "telephone_number": "703-644-5955",
            "fax_number": "703-644-1337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREGORY M IVY DDS AND CECILIA YKEDA DDS PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "YKEDA",
        "authorized_official_first_name": "CECILIA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "703-644-5955",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401410477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.