LEGACY DIALYSIS OF RESTON CLINIC NPI 1316643067

NPI Information

  • NPI: 1316643067
  • Provider Name: LEGACY DIALYSIS OF RESTON CLINIC
  • Classification: Clinic/Center - 261QE0700X
  • Specialization: End-Stage Renal Disease (ESRD) Treatment
  • Entity Type: Organization
  • Address: 1897 PRESTON WHITE DR STE 106
    RESTON, VA
    ZIP 20191
  • Phone: (954) 781-7741

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NPI Details

LEGACY DIALYSIS OF RESTON CLINIC is an end-stage renal disease (esrd) treatment clinic center in Reston, VA. LEGACY DIALYSIS OF RESTON CLINIC NPI is 1316643067. The provider is registered as an organization entity type.

The provider's business location address is:

1897 PRESTON WHITE DR STE 106
RESTON, VA
ZIP 20191-475
Phone: (954) 781-7741
Fax: (888) 349-8679

The provider's authorized official is Marcia Anjos Santos .
The authorized official title is Coo and has the following contact phone number (954) 781-7741.

The enumeration date for this NPI number is 2/3/2023 and was last updated on 2/26/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QE0700XClinic/CenterEnd-Stage Renal Disease (ESRD) TreatmentYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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