NPI Portal NPI Lookup & Verification

Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Deep Roots Periodontics Pllc

Periodontics in Fairfax, VA · enumerated 2012 · authorized official Taeheon Kang, Periodontis.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1255695243

Verified

See something wrong? Report a correction

Registry record

Entity type Organization (Type 2)
Legal business name Deep Roots Periodontics Pllc
Practice address 11130 Fairfax Blvd, Suite 100, Fairfax, VA, 22030
Phone (954) 536-1111
Enumeration date Jun 25, 2012
Last updated in NPPES Jun 25, 2012

Taxonomy & classification

1223P0300X Periodontics Dental Providers · License 0401-413327 (VA) Primary

Authorized official

Name Taeheon Kang
Title Periodontis
Phone (954) 536-1111

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

Who is the authorized official for Deep Roots Periodontics Pllc?
NPPES lists Taeheon Kang (Periodontis) as the authorized official for this organization.
What is the NPI number for Deep Roots Periodontics Pllc?
The NPI for Deep Roots Periodontics Pllc is 1255695243, a Type 2 (organization) record in the CMS NPPES registry.

Providers at this address

Browse all →

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2012-06-25.