Active NPI
Zack Hicham Mekouar, D.D.S.
- Orthodontics and Dentofacial Orthopedics Dentistry
- Woodbridge, VA
National Provider Identifier
1902092075
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 13390
- Practice address
- 13900 Noblewood PLZ
Woodbridge, VA 22193-1449 - Phone
- (703) 347-1282
- NPI assigned
- Sep 21, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 0401411070 | VA | |
| Dentist | 122300000X | DEN1000523 | DC | |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 13390 | MD | Primary |
Addresses
Primary practice location
13900 Noblewood PLZ
Woodbridge, VA 22193-1449
Mailing address
9616 Georgetown Pike
Great Falls, VA 22066-2638
Phone (703) 347-1282
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
| License | State | Type | Specialty |
|---|---|---|---|
| DEN1000523 | DC | MD | Dentist |
| 0401411070 | VA | MD | Dentist |
| 13390 | MD | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Leesburg Dental and Orthodontics, PLLC | Orthodontics and Dentofacial Orthopedics | Current | Accepting new patients |
| Elhady Dental 2 PLLC | Dentist | Past | Accepting new patients |
| Hicham Mekouar DDS PC | Dentist | Past | Accepting new patients |
Locations
135 Robinson Mill Plz SE
Ste 108
Leesburg, VA 20175
Phone (703) 347-1282
Organizations & group practices 3
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.
-
- General Practice Dentistry
- Leesburg, VA
- NPI 1437865342
Orthodontics and Dentofacial Orthopedics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661385600000",
"number": "1902092075",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9616 GEORGETOWN PIKE",
"city": "GREAT FALLS",
"state": "VA",
"postal_code": "220662638",
"telephone_number": "703-347-1282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13900 NOBLEWOOD PLZ",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221931449",
"telephone_number": "703-347-1282"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEKOUAR",
"first_name": "ZACK",
"middle_name": "HICHAM",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-09-21",
"last_updated": "2022-08-25",
"certification_date": "2022-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VA",
"license": "0401411070",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "DC",
"license": "DEN1000523",
"primary": false
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "MD",
"license": "13390",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodbridge, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.