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LEGACY DENTAL IMPLANT OF HERNDON
NPI 1053201384
Dentist - Periodontics in Herndon, VA

Active since July 08, 2025
208 ELDEN ST, HERNDON, VA 20170(646) 824-3829 Get Directions Write a Review

NPPES record last updated: July 8, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Legacy Dental Implant Of Herndon NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LEGACY DENTAL IMPLANT OF HERNDON (NPI 1053201384) is a healthcare organization registered as a periodontics in Herndon, Virginia and active in the NPI registry since July 2025. The organization lists Abdelrouf Suwid, Owner, as its authorized official.

NPPES Registry Identity

NPI1053201384
Entity TypeOrganization
Primary Taxonomy1223P0300X
Legal Business NameLEGACY DENTAL IMPLANT OF HERNDON
Location Address208 ELDEN STHerndon, VA 20170-4877
Mailing Address208 Elden StHerndon, VA 20170-4877 · (646) 824-3829
Phone(646) 824-3829
Organization SubpartNo
Authorized OfficialAbdelrouf SuwidOwner · (646) 824-3829
Enumeration DateJuly 8, 2025
NPPES CertifiedJuly 8, 2025
✔ NPI 1053201384 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers
Taxonomy Code1223P0300X
Definition
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.
208 ELDEN ST, Herndon, VA 20170
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HERNDON PHARMACY AND MEDICAL SUPPLY INC
Pharmacy (Community/Retail Pharmacy)
208 ELDEN ST
HERNDON, VA 20170
Fairfax County (202) 257-9240
OLIVER CHIROPRACTIC ACUPUNCTURE AND PHYSICAL THERAPY
Preferred Provider Organization
208 ELDEN ST
HERNDON, VA 20170
Fairfax County (703) 904-8528
AMAVI LLC
Pharmacy
208 ELDEN ST
HERNDON, VA 20170
Fairfax County (703) 481-0123
OLIVER CHIROPRACTIC & ACUPUNCTURE & PHYSICAL THERAPY LLC
Physical Therapist
208 ELDEN ST
HERNDON, VA 20170
Fairfax County (703) 904-8528

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Legacy Dental Implant Of Herndon's NPI number?

The NPI number for Legacy Dental Implant Of Herndon is 1053201384. It was assigned to this organization in the NPPES registry on July 8, 2025.

Where is Legacy Dental Implant Of Herndon located?

Legacy Dental Implant Of Herndon is located at 208 Elden St, Herndon, VA 20170. The listed phone number is (646) 824-3829.

What is Legacy Dental Implant Of Herndon's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

When was this NPI record last updated?

The NPPES record for Legacy Dental Implant Of Herndon was last updated on July 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.