ORAL AND FACIAL SURGERY CENTER OF VIRGINIA (NPI# 1891201802) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891201802 |
| Entity Type | Organization |
| Organization Name | ORAL AND FACIAL SURGERY CENTER OF VIRGINIA |
| Practice Address |
3787 Fettler Park Dr Ste A8 Dumfries VA 22025-1946 |
| Mailing Address |
3887 Fairfax Ridge Rd Apt 313 Fairfax VA 22030-7544 |
| Practice Telephone | 8572476414 |
| Enumeration Date | 2017-12-28 |
| Last Update Date | 2018-03-23 |
| Authorized Official Name | HASNAIN SHINWARI (PRESIDENT) |
| Authorized Official Telephone | 8572476414 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QD0000X |
Clinic/Center Specialization: Dental |
0401415066 | VA | Ambulatory Health Care Facilities |
| Y | 261QS0112X |
Clinic/Center Specialization: Oral and Maxillofacial Surgery |
0438000358 | VA | Ambulatory Health Care Facilities |
| Street Address |
3787 FETTLER PARK DR STE A8 |
| City | DUMFRIES |
| State | VA |
| Zip Code | 22025-1946 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023622230 | Joanne Perdu-ouimet | Behavioral Analyst | Incredible Changes, 4191 Waterway Dr., Dumfries, VA 22025 | 2020-09-04 |
| 1194287524 | Above and Beyond Therapy LLC | Speech-Language Pathologist | 15389 Autum Ln, Dumfries, VA 22025 | 2019-04-04 |
| 1669954095 | Renee L Roberts | Registered Nurse | 4222 Fortuna Center Plaza Ste 280, Dumfries, VA 22025 | 2018-09-01 |
| 1689044869 | Tracy Agyeman-badu | Pharmacist | 4310 Fortuna Village Center Plaza, Dumfries, VA 22025 | 2015-10-01 |
| 1588054316 | Tiffany Washington | Pharmacy Technician | 16224 Taconic Cir, Dumfries, VA 22025 | 2015-02-02 |
| 1568706158 | Boulevard Center Pediatrics | Pediatrics | 3733 Fettler Park Dr., Dumfries, VA 22025 | 2012-11-20 |
| 1205111796 | Khanh T Le | Pharmacist | 17506 Cajun Ct, Dumfries, VA 22025 | 2011-10-15 |
| 1679737761 | Shailesh K Gohel | Pediatrics | 3733 Fettler Park Dr, Dumfries, VA 22025 | 2008-07-17 |
| 1376616268 | Douglas Kendrick Chan | Physical Therapist | 3767 Fettler Park Drive, Dumfries, VA 22025 | 2006-11-16 |
| 1861596454 | Paul Wells Conrad | Dentist | 16150 Country Club Drive, Dumfries, VA 22025 | 2006-09-12 |
| Find all providers in zip 22025 | ||||
| Taxonomy Code | 261QS0112X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225425465 | Integrative Implant Services, LLC | Clinic/Center | 6845 Elm. St., Ste. 225, Mclean, VA 22102-3834 | 2015-04-24 |
| 1235424557 | Fredericksburg Regional Oral Surgery Center Inc | Clinic/Center | 210 Executive Center Pkwy, Fredericksburg, VA 22401-3107 | 2011-06-15 |
| 1720006661 | Christopher E. Bonacci Dds Md PC | Clinic/Center | 361 Maple Ave W, Suite 200, Vienna, VA 22180-4304 | 2006-07-18 |
| 1538629134 | Eric J Smith Dds PC | Clinic/Center | 22525 Timberlake Rd, Lynchburg, VA 24502-7307 | 2019-03-21 |
| 1922579796 | Eric J Smith Dds PC | Clinic/Center | 22525 Timberlake Rd, Lynchburg, VA 24502-7307 | 2018-12-05 |
| 1124572417 | Isle of Wight Family & Cosmetic Dentistry PC | Clinic/Center | 4053 Taylor Rd, Suite J, Chesapeake, VA 23321-5537 | 2016-08-04 |
| 1386050532 | Tristate Oral Surgery Plc | Clinic/Center | 5659 Columbia Pike, Suite 100, Falls Church, VA 22041-2878 | 2014-07-09 |
| 1831526995 | Northern Virginia Center for Oral and Facial Surgery | Clinic/Center | 4211 Fairfax Corner Ave E, Suite 235, Fairfax, VA 22030-8622 | 2013-10-03 |
| 1215292255 | Paul E. Prillaman, IIi, Dds, Plc | Clinic/Center | 905 Battlefield Blvd N, 101, Chesapeake, VA 23320-4875 | 2012-07-05 |
| 1891068417 | Middle Peninsula Oral and Facial Surgery LLC | Clinic/Center | 7547 Medical Dr, Gloucester, VA 23061-4351 | 2012-02-13 |
| Find all providers with the same taxonomy | ||||
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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.