Organization Active NPI

Smile Concept PLLC

  • General Practice Dentistry
  • Annandale, VA
National Provider Identifier
1952961971
Registry record updated Jun 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
SMILE CONCEPT PLLC
Practice address
7857 Heritage Dr Ste 320
Annandale, VA 22003-5350
Phone
(703) 721-4261
Fax
(703) 782-8347
NPI assigned
Jun 20, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2019

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

Authorized official

Name
Dr. Monica Eliana Chang, D.D.SNPI 1184857179
Title
Owner
Phone
(703) 721-4261

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
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

7857 Heritage Dr Ste 320
Annandale, VA 22003-5350

Mailing address

7857 Heritage Dr Ste 320
Annandale, VA 22003-5350
Phone (703) 721-4261

Other identifiers 1

IdentifierTypeStateIssuer
9225793MedicaidVA

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL ANNANDALE Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Locations

7857 Heritage Dr
Ste 320
Annandale, VA 22003
Phone (703) 721-4261

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1560988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560988800000",
    "number": "1952961971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7857 HERITAGE DR STE 320",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220035350",
            "telephone_number": "703-721-4261",
            "fax_number": "703-782-8347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7857 HERITAGE DR STE 320",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220035350",
            "telephone_number": "703-721-4261",
            "fax_number": "703-782-8347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE CONCEPT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-20",
        "last_updated": "2019-06-20",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "MONICA",
        "authorized_official_middle_name": "ELIANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-721-4261",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9225793",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ANNANDALE",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7857 Heritage Dr Ste 320",
            "city": "Annandale",
            "state": "VA",
            "country_code": "US",
            "postal_code": "220035350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Annandale, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2019; 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.