West End Implants and Periodontics, PLLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

WEST END IMPLANTS AND PERIODONTICS, PLLC

Practice address

7915 Lake Manassas Dr Ste 207
Gainesville, VA 20155-3260

Phone

(571) 261-4867

Fax

(571) 261-2522

NPI assigned

Feb 12, 2024

Organization subpart

No

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

Authorized official

Name

Rebecca L Blan

Title

Operations Manager

Phone

(571) 261-4867

Specialties & licenses 1

Addresses

Other names 1

• West End Implants & Periodontics Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Justin Hardison, D.M.D, M.S.D

  • Periodontics
  • Gainesville, VA
  • NPI 1114232527
  NPD

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

{
    "created_epoch": "1707696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707696000000",
    "number": "1932963790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7915 LAKE MANASSAS DR STE 207",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201553260",
            "telephone_number": "571-261-4867",
            "fax_number": "571-261-2522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7915 LAKE MANASSAS DR STE 207",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201553260",
            "telephone_number": "571-261-4867",
            "fax_number": "571-261-2522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST END IMPLANTS AND PERIODONTICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-12",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A",
        "authorized_official_last_name": "BLAN",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "571-261-4867"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West End Implants & Periodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Periodontics in Gainesville, VA
• Providers in Gainesville, VA by specialty
• Periodontics in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.