TDG Dental Group PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

TDG DENTAL GROUP PLLC

Practice address

3114 Golansky Blvd Ste 101
Woodbridge, VA 22192-4231

Phone

(703) 583-2800

NPI assigned

Nov 16, 2018

Organization subpart

No

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

Authorized official

Name

Stephanie Gomez

Title

Credentialing Supervisor

Phone

(305) 274-2499

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Ema Chohan, D.D.S.

  • Dentist
  • Manassas, VA
  • NPI 1770754509
  NPD (past)
• Mojgan Kakroudi Jamali, DDS

  • General Practice Dentistry
  • Manassas, VA
  • NPI 1225235344
  NPD (past)

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

{
    "created_epoch": "1542326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542326400000",
    "number": "1992274153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3114 GOLANSKY BLVD STE 101",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221924231",
            "telephone_number": "703-583-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3114 GOLANSKY BLVD STE 101",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221924231",
            "telephone_number": "703-583-2800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10630 Crestwood Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Manassas",
            "state": "VA",
            "postal_code": "201094405",
            "country_code": "US",
            "telephone_number": "703-330-5578",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TDG DENTAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-16",
        "last_updated": "2018-11-16",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "CREDENTIALING SUPERVISOR",
        "authorized_official_telephone_number": "305-274-2499"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Logan C Taylor
• Maha Balla Taylor, STUDENT
• Marcey Taylor, B.A.
• Monica Taylor, NP
• Florence Tchouaffi-Nana, M.D.
• TDS Health
• TDS Health
• TDS Health Home Care LLC
• Team Dental at River Oaks
• Helen Teferi

• General Practice Dentistry in Woodbridge, VA
• Providers in Woodbridge, 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 Nov 16, 2018; 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.