DR. HAROLD HARVEY FAGAN (NPI# 1174660856) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174660856 |
| Entity Type | Individual |
| Full Name | DR. HAROLD HARVEY FAGAN |
| Credential | D.D.S. |
| Practice Address |
4660 Kenmore Ave Suite 300 Alexandria VA 22304-1313 |
| Practice Telephone | 7038232422 |
| Practice Fax Number | 7038428671 |
| Mailing Telephone | 7038232422 |
| Mailing Fax Number | 7038428671 |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2008-08-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
0401004958 | VA | Dental Providers |
| Street Address |
4660 KENMORE AVE SUITE 300 |
| City | ALEXANDRIA |
| State | VA |
| Zip Code | 22304-1313 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841292091 | Lawrence R. Rubin | Internal Medicine | 4660 Kenmore Ave, Ste 1200, Alexandria, VA 22304-1311 | 2005-06-01 |
| 1316403645 | Felicia Cooper | Nurse Practitioner | 4660 Kenmore Ave, Alexandria, VA 22304-1313 | 2019-02-12 |
| 1659812832 | Northern Virginia Laboratory | Clinical Medical Laboratory | 4660 Kenmore Ave, Alexandria, VA 22304-1313 | 2017-03-20 |
| 1023472388 | Dakota Ferrell | Occupational Therapist | 4660 Kenmore Ave, Ste 400, Alexandria, VA 22304-1313 | 2016-04-12 |
| 1194198952 | Stephanie Anne Shaffer | Advanced Practice Midwife | 4660 Kenmore Ave, Suite 902, Alexandria, VA 22304-1313 | 2015-11-02 |
| 1396113270 | Cecelia Brown | Advanced Practice Midwife | 4660 Kenmore Ave, Suite 902, Alexandria, VA 22304-1313 | 2015-09-09 |
| 1437535358 | Kathleen Martin Bell | Nurse Practitioner | 4660 Kenmore Ave, Suite 902, Alexandria, VA 22304-1313 | 2015-08-03 |
| 1760866842 | Kimberly Ann Miller | Nurse Practitioner | 4660 Kenmore Ave, Suite 600, Alexandria, VA 22304-1313 | 2015-07-17 |
| 1649654716 | Nicole Lobo | Physical Therapy Assistant | 4660 Kenmore Ave, Suite 400, Alexandria, VA 22304-1313 | 2015-07-17 |
| 1336522986 | Elise Faith | Midwife | 4660 Kenmore Ave, Suite 902, Alexandria, VA 22304-1313 | 2015-07-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407489768 | Anthony Michael Frato | Counselor | 205 S Whiting St #601, Alexandria, VA 22304 | 2020-02-14 |
| 1245885805 | Personal Touch Personal Care Providers, LLC | In Home Supportive Care | 4241-d8 Duke Street, Alexandria, VA 22304 | 2019-08-09 |
| 1336658772 | Jade F. Hillery | Doula | 5240 Duke St #310, Alexandria, VA 22304 | 2017-09-28 |
| 1447784731 | Aymara Matos | Behavioral Analyst | 5426 Richenbacher Ave Apt 100, Alexandria, VA 22304 | 2017-04-13 |
| 1659827871 | Tesfaye A Hailemariam Dds PC | Dentist | 5764 Dow Ave, Alexandria, VA 22304 | 2016-08-28 |
| 1912302605 | Alexandria Health Department | Clinic/Center | 1200 North Howard, Alexandria, VA 22304 | 2014-10-24 |
| 1497157663 | Aminata Jalloh | Registered Nurse | 101 South Whiting St, Alexandria, VA 22304 | 2014-09-19 |
| 1386075133 | Carla Renee Riley | Registered Nurse | 4320 Raleigh Ave, Apt 204, Alexandria, VA 22304 | 2013-12-04 |
| 1700223500 | Landmark Dental Care | Dentist | 101 S. Whiting St., Suite 100, Alexandria, VA 22304 | 2013-06-03 |
| 1114266954 | Stella M Meusch | Physician Assistant | 4230 Seminary Rd, Alexandria, VA 22304 | 2013-02-13 |
| Find all providers in zip 22304 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750860516 | Khashayar Kordbacheh Changi | Dentist | 3543 W Braddock Rd Ste E2, Alexandria, VA 22302-1903 | 2018-08-11 |
| 1487709846 | Karl Allen Smith | Dentist | 2500 N Van Dorn St Ste 128, Alexandria, VA 22302-1601 | 2007-01-24 |
| 1114035573 | David Carlson Anderson | Dentist | 5288 Dawes Ave, Alexandria, VA 22311 | 2006-08-27 |
| 1356365126 | Mark Richard Gordon | Dentist | 2121 Eisenhower Ave, Suite 502, Alexandria, VA 22314-4698 | 2006-07-26 |
| 1992002075 | Dima Lakkis | Dentist | 4660 Kenmore Ave, Alexandria, VA 22304-1313 | 2011-02-25 |
| 1528104262 | David Sarment | Dentist | 4660 Kenmore Ave, Suite 312, Alexandria, VA 22304-1313 | 2007-01-29 |
| 1669570586 | Justin D Zalewsky | Dentist | 4660 Kenmore Ave, Suite 300, Alexandria, VA 22304-1313 | 2006-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497361471 | Lisa A. Marvil, D.m.d., P.l.l.c. | Dentist | 17341-b Pickwick Drive, Purcellville, VA 20132 | 2020-09-16 |
| 1720624307 | Deena Hadithi Dmd, PC. | Dentist | 7210 Old Keene Mill Rd Ste 3, Springfield, VA 22150-3442 | 2019-11-19 |
| 1689223836 | Alka Panwar | Dentist | 4319 Dale Blvd Ste 6, Woodbridge, VA 22193-2401 | 2019-09-10 |
| 1801445135 | Neha Agarwal | Dentist | 23386 Epperson Sq, Brambleton, VA 20148-5794 | 2019-09-09 |
| 1164999181 | Smba Dentistry, Pllc | Dentist | 2801 Mcrae Rd Ste C1, North Chesterfield, VA 23235-3056 | 2018-10-29 |
| 1205314309 | Shivangi B Amin | Dentist | 2420 Old Brick Rd Apt 1315, Glen Allen, VA 23060-5995 | 2018-07-31 |
| 1881107100 | New River Periodontics and Dental Implant Center, PC | Dentist | 2612 Sheffield Drive, Blacksburg, VA 24060 | 2017-11-08 |
| 1740793355 | Amy Ton Dds Pllc | Dentist | 11868 Sunrise Valley Dr Ste 100, Reston, VA 20191-3320 | 2017-11-06 |
| 1023539301 | Denver James Lyons | Dentist | 521 N 11th St # 980566, Richmond, VA 23298-5045 | 2017-06-27 |
| 1194258095 | Rashmi Ganesh | Dentist | 23371 Bymes Mill Ter, Ashburn, VA 20148-8112 | 2017-04-06 |
| Find all providers with the same taxonomy | ||||
| City | ALEXANDRIA |
| Zip Code | 22304 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.