Organization Active NPI

Oral Surgery Associates of Northern Virginia, LTD.

  • Oral and Maxillofacial Surgery (Dentist)
  • Alexandria, VA
National Provider Identifier
1962693051
Registry record updated Sep 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
0401006414 Issued in VA
Legal business name
ORAL SURGERY ASSOCIATES OF NORTHERN VIRGINIA, LTD.
Practice address
101 S Whiting St
Suite 106
Alexandria, VA 22304-3418
Phone
(703) 751-7841
NPI assigned
Aug 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2011

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

Authorized official

Name
Dr. James Albert Pell, DDSNPI 1598738338
Title
President
Phone
(703) 751-7841

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
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 0401006414 VA Primary

Addresses

Primary practice location

101 S Whiting St
Suite 106
Alexandria, VA 22304-3418

Mailing address

101 S Whiting St
Suite 106
Alexandria, VA 22304-3418
Phone (703) 751-7841

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040820000219 DC Part B Supplier - Clinic/Group Practice 0941274542 Receives reassigned benefits from 1 practitioner
Practice locations: Reston, VA
O20170927001405 VA Part B Supplier - Clinic/Group Practice 0941274542 Receives reassigned benefits from 1 practitioner
Practice locations: Woodbridge, VA

National Provider Directory

National Provider Directory

Locations

101 S Whiting St
Ste 106
Alexandria, VA 22304
Phone (571) 257-8634

1800 Town Center Dr
Ste 116
Reston, VA 20190
Phone (703) 435-4414

1800 Town Center Dr
Ste 1
Reston, VA 20190

3158 Golansky Blvd
Woodbridge, VA 22192

3158 Golansky Blvd
Ste 102
Woodbridge, VA 22192
Phone (703) 897-8983

Practitioners & affiliated clinicians

Practitioners 6

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": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315958400000",
    "number": "1962693051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S WHITING ST",
            "address_2": "SUITE 106",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223043418",
            "telephone_number": "703-751-7841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S WHITING ST",
            "address_2": "SUITE 106",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223043418",
            "telephone_number": "703-751-7841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORAL SURGERY ASSOCIATES OF NORTHERN VIRGINIA, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-05",
        "last_updated": "2011-09-14",
        "status": "A",
        "authorized_official_last_name": "PELL",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "ALBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-751-7841",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "VA",
            "license": "0401006414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.