Organization Active NPI

Al Dental

Doing business as Bolduc Dental

  • Dentist
  • Vienna, VA
National Provider Identifier
1922825561
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
AL DENTAL
Practice address
301 Maple Ave W Ste 300
Vienna, VA 22180-4301
Phone
(703) 242-4555
Fax
(703) 242-6770
NPI assigned
Sep 24, 2024
Last updated
Sep 24, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Authorized official

Name
Dr. Yasser AlhabashiNPI 1790341519
Title
Dentist
Phone
(703) 242-4555

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

301 Maple Ave W Ste 300
Vienna, VA 22180-4301

Mailing address

301 Maple Ave W Ste 300
Vienna, VA 22180-4301
Phone (703) 242-4555

Other names 1

  • Bolduc Dental Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1727136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727136000000",
    "number": "1922825561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 MAPLE AVE W STE 300",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221804301",
            "telephone_number": "703-242-4555",
            "fax_number": "703-242-6770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MAPLE AVE W STE 300",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221804301",
            "telephone_number": "703-242-4555",
            "fax_number": "703-242-6770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AL DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-24",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A",
        "authorized_official_last_name": "ALHABASHI",
        "authorized_official_first_name": "YASSER",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "703-242-4555",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bolduc Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bolduc Dental",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Vienna, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; 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.