Active NPI
Sanaz Derakhshan
- Pharmacist
- Chantilly, VA
National Provider Identifier
1902406473
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202211064
- Practice address
- 42952 Beachall St
Chantilly, VA 20152-2013 - Phone
- (170) 394-4009
- NPI assigned
- Oct 26, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202211064 | VA | Primary |
Addresses
Primary practice location
42952 Beachall St
Chantilly, VA 20152-2013
Mailing address
42015 Village Center PLZ
Aldie, VA 20105-3033
Phone (703) 944-0099
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 |
|---|---|---|---|
| 0202211064 | VA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603670400000",
"number": "1902406473",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "42015 VILLAGE CENTER PLZ",
"city": "ALDIE",
"state": "VA",
"postal_code": "201053033",
"telephone_number": "703-944-0099"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "42952 BEACHALL ST",
"city": "CHANTILLY",
"state": "VA",
"postal_code": "201522013",
"telephone_number": "170-394-4009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DERAKHSHAN",
"first_name": "SANAZ",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-26",
"last_updated": "2020-10-26",
"certification_date": "2020-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pharmacist",
"state": "VA",
"license": "0202211064",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chantilly, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.