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SUMAN SETHI DDS
NPI 1861874018
Dentist - Pediatric Dentistry in Herndon, VA

Active since June 24, 2015PECOS Enrolled
13015 WORLDGATE DR, HERNDON, VA 20170(703) 429-4619 Get Directions Write a Review

NPPES record last updated: January 24, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Suman Sethi Dds NPPES

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

SUMAN SETHI DDS (NPI 1861874018) is an individual pediatric dentistry provider in Herndon, Virginia, licensed in Alabama (D.007273-C) and active in the NPI registry since June 2015. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1861874018
Entity TypeIndividualFemale
Primary Taxonomy1223P0221X
Provider Legal NameSUMAN SETHICredential: DDS
Location Address13015 WORLDGATE DRHerndon, VA 20170-4374
Mailing Address13015 Worldgate DrHerndon, VA 20170-4374 · (703) 429-4619
Phone(703) 429-4619
Sole ProprietorYes
Enumeration DateJune 24, 2015
Last NPPES UpdateJanuary 24, 2024
NPPES CertifiedJanuary 24, 2024
✔ NPI 1861874018 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
Licenses✔ Licensed in AL · D.007273-C✔ Licensed in VA · 0401416139
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
13015 WORLDGATE DR, Herndon, VA 20170
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Suman Sethi Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 20170 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$100.31 typical visit price
range $65.18 – $194.86
Typical copayment $25.07 (range $16.29 – $48.71)
Most-billed visit code 99203
Established Patient
$80.66 typical visit price
range $21.40 – $158.88
Typical copayment $20.16 (range $5.35 – $39.72)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

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

LET'S SMILE ORTHO HERNDON, PLLC
Clinic/Center (Dental)
13015 WORLDGATE DR
HERNDON, VA 20170
Fairfax County (703) 719-5828
DENTISTRY FOR CHILDREN OF VIRGINIA LLC
Dentist (Pediatric Dentistry)
13015 WORLDGATE DR
HERNDON, VA 20170
Fairfax County (404) 389-1950
LET'S SMILE OF HERNDON, PLLC
Clinic/Center (Dental)
13015 WORLDGATE DR
HERNDON, VA 20170
Fairfax County (703) 719-5828

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 Suman Sethi's NPI number?

The NPI number for Suman Sethi is 1861874018. It was assigned to this individual provider in the NPPES registry on June 24, 2015.

Where is Suman Sethi located?

Suman Sethi practices at 13015 Worldgate Dr, Herndon, VA 20170. The listed phone number is (703) 429-4619.

What is Suman Sethi's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

Is Suman Sethi enrolled in Medicare?

Yes. Suman Sethi is registered in the Medicare PECOS enrollment system.

What insurance does Suman Sethi accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Alabama, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 8 other insurers list Suman Sethi as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Suman Sethi was last updated on January 24, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.