NPIMap

Organization Active NPI

Dulles Oral Surgical Center

  • Clinic/Center
  • Chantilly, VA
National Provider Identifier
1992011233
Registry record updated Aug 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
0438000264 Issued in VA
Legal business name
DULLES ORAL SURGICAL CENTER
Practice address
24805 Pinebrook Rd Ste 100
Chantilly, VA 20152-4127
Phone
(703) 327-0955
Fax
(703) 327-0956
NPI assigned
Aug 24, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2010

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

Authorized official

Name
Edward Auduborn Longwe, DDSNPI 1689886640
Title
Director
Phone
(703) 327-0955

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
Clinic/Center 261Q00000X 0438000264 VA Primary

Addresses

Primary practice location

24805 Pinebrook Rd Ste 100
Chantilly, VA 20152-4127

Mailing address

24805 Pinebrook Rd Ste 100
Chantilly, VA 20152-4127
Phone (703) 327-0955

National Provider Directory

National Provider Directory
Tax ID family
Dulles Oral Surgical Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

24805 Pinebrook Rd
Ste 100
Chantilly, VA 20152
Phone (703) 327-0955

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

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": "1282608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282608000000",
    "number": "1992011233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24805 PINEBROOK RD STE 100",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201524127",
            "telephone_number": "703-327-0955",
            "fax_number": "703-327-0956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24805 PINEBROOK RD STE 100",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201524127",
            "telephone_number": "703-327-0955",
            "fax_number": "703-327-0956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DULLES ORAL SURGICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-24",
        "last_updated": "2010-08-24",
        "status": "A",
        "authorized_official_last_name": "LONGWE",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "AUDUBORN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "703-327-0955",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "VA",
            "license": "0438000264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chantilly, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2010; 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.