Deep Roots Periodontics PLLC
NPI 1255695243ActiveOrganization· Dentist, Periodontics· Fairfax, VA
Dentist, Periodontics in Fairfax, Virginia, registered in NPPES in June 2012. The authorized official on file is Taeheon Kang, D.D.S., M.S., Periodontis.
Overview
| NPI | 1255695243 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 25, 2012 |
| Last updated in NPPES | Jun 25, 2012 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, Periodontics Primary | 1223P0300X | 0401-413327 | VA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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