DALEWOOD MEDICAL ENT
NPI 1174549265
Legal Medicine in Dale City, VA
NPI Status: Active since July 14, 2006
Contact Information
4158 DALE BLVD
DALE CITY, VA
ZIP 22193
Phone: (703) 680-5959
Fax: (703) 730-1046
- Organization
- Legal Medicine
- CLIA Number: 49D2114915
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 06-28-2025
About DALEWOOD MEDICAL ENT
This page provides the complete NPI Profile along with additional information for Dalewood Medical Ent, a provider established in Dale City, Virginia operating as a Legal Medicine. The healthcare provider is registered in the NPI registry with number 1174549265 assigned on July 2006. The practitioner's primary taxonomy code is 173000000X. The provider is registered as an organization and their NPI record was last updated 18 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Jennifer Kulak (Office Manager)
- NPI
- 1174549265
- Provider Name
- DALEWOOD MEDICAL ENT
- Entity Type
- Organization
- Location Address
- 4158 DALE BLVD DALE CITY, VA 22193
- Location Phone
- (703) 680-5959
- Location Fax
- (703) 730-1046
- Mailing Address
- 4158 DALE BLVD DALE CITY, VA 22193
- Mailing Phone
- (703) 680-5959
- Mailing Fax
- (703) 730-1046
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 07-14-2006
- Last Update Date
- 12-27-2007
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Legal Medicine
- Taxonomy Code
- 173000000X
- Type
- Other Service Providers
- Taxonomy Description
- The specialty areas of medicine concerned with matters of, and relations with, substantive law and legal institutions; such as the conduct of medical examinations at crime scenes, performance of autopsies, giving of expert medical testimony in judicial proceedings, medical treatment of inmates of penal institutions, the practice of trauma medicine in law enforcement settings, and other clinical practice and medical science applications in the fields of law, law enforcement, and corrections.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| C02465 | MEDICARE PIN (08) | VA |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 49D2114915
- Facility Type
- Physician Office
- Certificate Effective Date
- June 29, 2023
- Certificate Expiration Date
- June 28, 2025
- Laboratory Director
- NEDA MOTAMENI
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Dalewood Medical Ent to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for DALEWOOD MEDICAL ENT
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 1 | 7 | 4 | 5 | 4 | 9 | 2 | 6 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 14 | 4 | 10 | 4 | 18 | 2 | 12 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 1 + 4 + 4 + 1 + 0 + 4 + 1 + 8 + 2 + 1 + 2 + 24 = 55 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 55 = 5 | 5 | ||||||||
The NPI number 1174549265 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 4 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1023034709 | LJUBICA AZER M.D. Individual | Legal Medicine | 4158 DALE BLVD DALE CITY, VA 22193 (703) 680-5959 |
| 1780040196 | URGE MEDICAL Organization | Clinic/Center (Urgent Care) | 4158 DALE BLVD WOODBRIDGE, VA 22193 (703) 680-5959 |
| 1518635143 | LAUREN MICHELLE MULLER PA-C Individual | Physician Assistant | 4158 DALE BLVD WOODBRIDGE, VA 22193 (703) 680-5959 |
| 1326829854 | ALHAJI JALLOH MSN, APRN,FNP-C Individual | Nurse Practitioner (Family) | 4158 DALE BLVD WOODBRIDGE, VA 22193 (703) 349-9501 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1174549265, enumerated in the NPI registry as an "organization" on July 14, 2006
The provider is located at 4158 Dale Blvd Dale City, Va 22193 and the phone number is (703) 680-5959
This medical organization specializes in Legal Medicine with taxonomy code 173000000X
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 49D2114915 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on July 14, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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