Individual provider Active NPI

Geetika Tahim, DDS

  • Dentist
  • Herndon, VA
National Provider Identifier
1912144130
Registry record updated Nov 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401411507 Issued in VA
Practice address
110 Elden St Ste B
Herndon, VA 20170-4887
Phone
(703) 437-1800
NPI assigned
Jan 9, 2009
Last updated
Nov 22, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401411507 VA Primary

Addresses

Primary practice location

110 Elden St Ste B
Herndon, VA 20170-4887

Mailing address

110 Elden St Ste B
Herndon, VA 20170-4887
Phone (703) 437-1800

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

LicenseStateTypeSpecialty
0401411507VAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1231459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637539200000",
    "number": "1912144130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 ELDEN ST STE B",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704887",
            "telephone_number": "703-437-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 ELDEN ST STE B",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704887",
            "telephone_number": "703-437-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAHIM",
        "first_name": "GEETIKA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-09",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401411507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Herndon, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; 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.