DR. JAKLIN BEZIK & ASSOCIATES (NPI# 1780997288) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780997288 |
| Entity Type | Organization |
| Organization Name | DR. JAKLIN BEZIK & ASSOCIATES |
| Practice Address |
11150 Fairfax Bulvard #301 Fairfax VA 22030 |
| Mailing Address |
11150 Fairfax Blvard #301 Fairfax VA 22030 |
| Practice Telephone | 7039344474 |
| Mailing Telephone | 7039344474 |
| Enumeration Date | 2010-07-26 |
| Last Update Date | 2010-07-26 |
| Authorized Official Name | DR. JAKLIN BEZIK (PRESIDENT) |
| Authorized Official Telephone | 7039344474 |
| Authorized Official Credential | DDS, MDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223P0300X |
Dentist Specialization: Periodontics |
DEN1000297 | DC | Dental Providers |
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
0401410580 | VA | Dental Providers |
| Street Address |
11150 FAIRFAX BULVARD #301 |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22030 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205449477 | Perry Camp Jr. | Psychologist | 4403 Dixie Hill Rd, Unit 205, Fairfax, VA 22030 | 2020-08-28 |
| 1952940322 | Brightview Fair Oaks, LLC | Alzheimer Center (Dementia Center) | 12725 Lee Highway, Fairfax, VA 22030 | 2020-01-02 |
| 1245871524 | Tori Sprowl | Behavioral Analyst | 10430 Democracy Lane #102b & 103, Fairfax, VA 22030 | 2019-10-08 |
| 1528612124 | Paul Sarigianis | Student in an Organized Health Care Education/Training Program | 10379b Democracy Lane, Fairfax, VA 22030 | 2019-07-31 |
| 1497221303 | Kahak, Inc. | Day Training, Developmentally Disabled Services | 10560 Main Street Suite Ps100, Fairfax, VA 22030 | 2018-10-17 |
| 1689177073 | Shamoona Sharif | Dentist | 11050 Lee Hwy, Fairfax, VA 22030 | 2018-03-13 |
| 1205339538 | Rachael Lee Greene | Social Worker | 4403 Dixie Hill Rd. #206, Fairfax, VA 22030 | 2018-03-13 |
| 1558863027 | Jacqueline Renee Bauer | Skilled Nursing Facility | 10701 Main Street, Fairfax, VA 22030 | 2018-03-01 |
| 1275033607 | Philajo Global LLC | Non-emergency Medical Transport (VAN) | 4521 Billingham Street, Fairfax, VA 22030 | 2018-02-12 |
| 1376050401 | Alexander Harrison | Counselor | 4400 University Drive, Ms 2a2, Fairfax, VA 22030 | 2018-01-10 |
| Find all providers in zip 22030 | ||||
| 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 |
|---|---|---|---|---|
| 1174802623 | Edison A Abril | Dentist | 4210 Mozart Brigade Ln, Apartment Y, Fairfax, VA 22033-3906 | 2011-08-15 |
| 1215135579 | Richard Usang Koh | Dentist | 13035 Lee Jackson Memorial Hwy, Suite D, Fairfax, VA 22033-2039 | 2007-07-10 |
| 1720125321 | William T. Ryals Jr. | Dentist | 10621 Braddock Rd, Suite D, Fairfax, VA 22032-2200 | 2007-01-31 |
| 1306939335 | Gregory Nosal | Dentist | 9514c Lee Hwy, Fairfax, VA 22031-2303 | 2006-10-02 |
| 1639172620 | Michael Edwin Oppenheimer | Dentist | 9938 Main St, Fairfax, VA 22031-3901 | 2005-05-24 |
| 1356887400 | Sandra Pacios Pujado | Dentist | 3224 Cambridge Ct, Fairfax, VA 22030-1912 | 2017-01-12 |
| 1255695243 | Deep Roots Periodontics Pllc | Dentist | 11130 Fairfax Blvd, Suite 100, Fairfax, VA 22030-5035 | 2012-06-25 |
| 1568735785 | Vikas Puri | Dentist | 11150 Fairfax Blvd, Fairfax, VA 22030-5066 | 2012-02-18 |
| 1639399306 | Ira M Rosenthal | Dentist | 9661 Main St, Suite C, Fairfax, VA 22031-3757 | 2007-04-26 |
| 1356480552 | Jaklin Bezik | Dentist | 11150 Fairfax Blvd, 301, Fairfax, VA 22030-5066 | 2007-02-05 |
| Find all providers in FAIRFAX | ||||
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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.