Bloom Dental, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401413246 Issued in VA

Legal business name

BLOOM DENTAL, PLLC

Practice address

900 N Randolph St Ste 103
Arlington, VA 22203-1949

Phone

(703) 243-3600

NPI assigned

Jul 12, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Ashkan Yousefi, DDSNPI 1336429281

Title

Owner

Phone

(408) 888-9240

Specialties & licenses 2

Addresses

Locations

Practitioners 1

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

• Ashkan Yousefi, DMD

  • Dentist
  • Washington, DC
  • NPI 1336429281
  NPD (past) Authorized official

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

{
    "created_epoch": "1499817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499817600000",
    "number": "1992227870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 N RANDOLPH ST STE 103",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222031949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N RANDOLPH ST STE 103",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222031949",
            "telephone_number": "703-243-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOM DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-12",
        "last_updated": "2017-07-12",
        "status": "A",
        "authorized_official_last_name": "YOUSEFI",
        "authorized_official_first_name": "ASHKAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "408-888-9240",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401415049",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401413246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maxwell Blake
• Jacqueline Angelica Blakely
• Norma Blann, RPH
• Chandreea K Blanton
• Natalie Block-Levin, LCSW
• Bloom Speech Therapy, PLLC
• Allyson Green Bloom, MD
• Amy Sue Bloom, M.D.
• Anne Welch Bloom, ARNP
• Danielle E Bloom, PT

• General Practice Dentistry in Arlington, VA
• Providers in Arlington, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2017; 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.