DR. OLMEDO IVAN VILLAVICENCIO (NPI# 1013059450) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013059450 |
| Entity Type | Individual |
| Full Name | DR. OLMEDO IVAN VILLAVICENCIO |
| Credential | D.D.S. |
| Practice Address |
7501 Little River Tpke Ste 105 Annandale VA 22003-2923 |
| Practice Telephone | 7033542878 |
| Practice Fax Number | 7033542712 |
| Mailing Telephone | 7033542878 |
| Mailing Fax Number | 7033542712 |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
0401007760 | VA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730496100 | Olmedo Eloy Villavicencio | Pediatrics | 601 S Carlin Springs Rd, Arlington, VA 22204-1044 | 2010-09-08 |
| Street Address |
7501 LITTLE RIVER TPKE STE 105 |
| City | ANNANDALE |
| State | VA |
| Zip Code | 22003-2923 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932741758 | Lien Hong Do | Pharmacist | 4014 Thornton Street, Annandale, VA 22003 | 2019-10-14 |
| 1639655376 | Brian D Blincoe | Military Health Care Provider | 7207 Masonville Drive, Annandale, VA 22003 | 2018-07-16 |
| 1790201481 | Mid Atlantic Plastic Surgeons LLC | Plastic Surgery | 3301 Woodburn Road, Suite 202, Annandale, VA 22003 | 2017-08-15 |
| 1053841668 | Rosalie Zuniga | Social Worker | 6800 Algonquin Court, Annandale, VA 22003 | 2017-06-15 |
| 1386179133 | Adaptive Care LLC | In Home Supportive Care | 4603 Logsdon Drive, Annandale, VA 22003 | 2017-04-28 |
| 1457808933 | Evergreen Foot and Ankle LLC | Podiatrist | 6928 Little River Turnpike, Suite B, Annandale, VA 22003 | 2016-09-01 |
| 1093165672 | Brightview Fairfax, LLC | Alzheimer Center (Dementia Center) | 3450 Gallows Road, Annandale, VA 22003 | 2016-06-15 |
| 1063867844 | Sports Care Acupuncture Clinic, LLC | Acupuncturist | 7535 Little River Tnpk #103a, Annandale, VA 22003 | 2016-04-28 |
| 1578925806 | Nu Dimensions, LLC | Day Training, Developmentally Disabled Services | 3602 Balin Ct, Annandale, VA 22003 | 2016-03-25 |
| 1932505641 | Julia Jiyoung Lee | Acupuncturist | 7535 Little River Tnpk, Suite 103a, Annandale, VA 22003 | 2014-11-06 |
| Find all providers in zip 22003 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952961971 | Smile Concept Pllc | Dentist | 7857 Heritage Dr Ste 320, Annandale, VA 22003-5350 | 2019-06-20 |
| 1710378716 | Mobolaji Falaiye | Dentist | 7719 Rowan Ct, Annandale, VA 22003-5426 | 2015-02-11 |
| 1568875201 | Danny Vo | Dentist | 4305 Americana Dr, Apt #10, Annandale, VA 22003-4716 | 2014-06-10 |
| 1740547504 | Gopal S. Pal Dds. Ms | Dentist | 7540 Little River Turnpike, Suite A, Annandale, VA 22003 | 2012-04-18 |
| 1417225376 | Vu D Tran | Dentist | 6922 Little River Tpke, Suite #a, Annandale, VA 22003-3285 | 2011-12-07 |
| 1831408087 | Yen V, Le, D.d.s., P.C. | Dentist | 4216 Evergreen Ln Ste 113, Annandale, VA 22003-3253 | 2010-10-05 |
| 1659509453 | Andrew Loren Betaharon | Dentist | 8400 Kay Ct, Annandale, VA 22003-2206 | 2009-06-30 |
| 1003053984 | Eul-mo Kang | Dentist | 4540a John Marr Dr, Annandale, VA 22003 | 2009-01-14 |
| 1275703274 | Linh Thuy-do Tran | Dentist | 4200 Evergreen Ln, Suite 325, Annandale, VA 22003-3245 | 2008-03-05 |
| 1780865428 | Garden State Dental Group LLC | Dentist | 1 Hook Mountain Dr, Annandale, NJ 08801-2003 | 2007-11-23 |
| Find all providers in ANNANDALE | ||||
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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.