Active NPI
Michael Charles Mocknick, D.M.D.
- Dentist
- MC Lean, VA
National Provider Identifier
1992962070
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 0401008063
- Practice address
- 6845 Elm St
Suite 509
MC Lean, VA 22101-6007 - Phone
- (703) 734-0334
- NPI assigned
- May 17, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 0401008063 | VA | Primary |
| Endodontics | 1223E0200X | 9122 | MD |
Addresses
Primary practice location
6845 Elm St
Suite 509
MC Lean, VA 22101-6007
Mailing address
6845 Elm St
Suite 509
MC Lean, VA 22101-6007
Phone (703) 734-0334
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401008063 | VA | MD | Dentist |
| 9122 | MD | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210982400000",
"number": "1992962070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6845 ELM ST",
"address_2": "SUITE 509",
"city": "MC LEAN",
"state": "VA",
"postal_code": "221016007",
"telephone_number": "703-734-0334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6845 ELM ST",
"address_2": "SUITE 509",
"city": "MC LEAN",
"state": "VA",
"postal_code": "221016007",
"telephone_number": "703-734-0334"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOCKNICK",
"first_name": "MICHAEL",
"middle_name": "CHARLES",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-17",
"last_updated": "2008-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VA",
"license": "0401008063",
"primary": true
},
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "MD",
"license": "9122",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in MC Lean, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.