CMS-1500 Box 24J / 33a • NPI
1093889008
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
1223S0112X (CMS 19)
Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)
Box 32 Service Location & ZIP+4
19441 GOLF VISTA PLAZA, SUITE 130, LANSDOWNE, VA, 20176
Official NPPES Practice Location
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1093889008 (BARRY R. MAHARAJ, DDS & ANH H. PHAM, DDS, PC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1093889008 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | BARRY R. MAHARAJ, DDS & ANH H. PHAM, DDS, PC |
| Plain-English Specialty | Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) NUCC Code: 1223S0112X (Dentist, Oral and Maxillofacial Surgery) |
| Certifying / Licensing Body | American Dental Association (ADA) / State Board of Dental Examiners |
| Practice Location Address | 19441 GOLF VISTA PLAZA, SUITE 130, LANSDOWNE, VA, 20176 |
| Practice Telephone / Fax | Tel: (703) 723-7858 | Fax: (703) 723-7882 |
| Administrative Mailing Address | 19441 GOLF VISTA PLAZA, LANSDOWNE, VA, 20176 |
| Enumeration & Last Sync | Enumerated: 2006-11-20 | CMS Record Updated: 2013-08-21 |
| Authorized Official | KAITI GRIM (Administrative Dirct) |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (1223S0112X)
What Does Taxonomy Code 1223S0112X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 1223S0112X translates to:
"Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (BARRY R. MAHARAJ, DDS & ANH H. PHAM, DDS, PC)
Typical CPT / Diagnostic Procedures:- Comprehensive Oral Evaluation, Digital Dental Radiographs & Prophylaxis
- Restorative Composite Fillings, Crowns, Endodontic Root Canal & Extractions
- Amoxicillin, Metronidazole & Clindamycin (Odontogenic Infections)
- Chlorhexidine Gluconate 0.12% Oral Rinse & High-Fluoride Varnish
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
1223S0112X — Dentist, Oral and Maxillofacial SurgeryPlain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) | State: N/A | License: Verified | Primary: Secondary |
1223S0112X — Dentist, Oral and Maxillofacial SurgeryPlain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) | State: VA | License: 0401410305 | Primary: Secondary |
1223S0112X — Dentist, Oral and Maxillofacial SurgeryPlain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) | State: VA | License: 0401413171 | Primary: Secondary |
1223S0112X — Dentist, Oral and Maxillofacial SurgeryPlain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) | State: VA | License: 0401006304 | Primary: Yes (Primary) |
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