NPIMap

Organization Active NPI

Crystal City Dental Arts Center

  • General Practice Dentistry
  • Arlington, VA
National Provider Identifier
1932467180
Registry record updated Apr 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401007352 Issued in VA
Legal business name
CRYSTAL CITY DENTAL ARTS CENTER
Practice address
1615-E Crystal Square Arcade
Arlington, VA 22202
Phone
(202) 599-9100
NPI assigned
Apr 25, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2012

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

Authorized official

Name
Dr. Jason Favagehi, DDS
Title
President
Phone
(703) 356-1200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 0401007352 VA Primary

Addresses

Primary practice location

1615-E Crystal Square Arcade
Arlington, VA 22202

Mailing address

8304-C Old Courthouse Rd.
Vienna, VA 22182
Phone (703) 356-1200

National Provider Directory

National Provider Directory

Locations

1615 Crystal Square Arc
Arlington, VA 22202
Phone (202) 599-9100

NPI Registry JSON

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

{
    "created_epoch": "1335312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335312000000",
    "number": "1932467180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8304-C OLD COURTHOUSE RD.",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "22182",
            "telephone_number": "703-356-1200",
            "fax_number": "703-356-6742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615-E CRYSTAL SQUARE ARCADE",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "22202",
            "telephone_number": "202-599-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL CITY DENTAL ARTS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-25",
        "last_updated": "2012-04-25",
        "status": "A",
        "authorized_official_last_name": "FAVAGEHI",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-356-1200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401007352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2012; 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.