Modern Orthodontics

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

0401413531 Issued in VA

Legal business name

MODERN ORTHODONTICS

Practice address

10298 Bristow Center Dr
Bristow, VA 20136-2200

Phone

(703) 436-0006

NPI assigned

Nov 6, 2013

Last updated

Jan 10, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Nikolay Dimitrov Mollov, DDS, MS

Title

Vice-President

Phone

(703) 436-0006

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1383696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389312000000",
    "number": "1932538253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10298 BRISTOW CENTER DR",
            "city": "BRISTOW",
            "state": "VA",
            "postal_code": "201362200",
            "telephone_number": "703-436-0006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10298 BRISTOW CENTER DR",
            "city": "BRISTOW",
            "state": "VA",
            "postal_code": "201362200",
            "telephone_number": "703-436-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN ORTHODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-06",
        "last_updated": "2014-01-10",
        "status": "A",
        "authorized_official_last_name": "MOLLOV",
        "authorized_official_first_name": "NIKOLAY",
        "authorized_official_middle_name": "DIMITROV",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "703-436-0006",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "VA",
            "license": "0401413531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Naglaa Boutros Moussa, LPC
• Ashley C Movius
• Henriette Mutombo
• Myeyedr Optometry of Virginia, PLLC (MyEyeDr.)

• Orthodontics and Dentofacial Orthopedics Dentistry in Bristow, VA
• Providers in Bristow, VA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2014; 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.