Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1780774299 Individual Practitioner Male Practitioner

Dr. Walter Collazo , DDS

Dentist - General Practice • Leesburg, VA

Professional Overview & Biography Verified Profile Summary

Dr. Walter Collazo, DDS is a registered healthcare professional specializing in Dentist - General Practice in Leesburg, VA. Practice services are available at 1614 VILLAGE MARKET BLVD SE STE 100 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1614 Village Market Blvd Se Ste 100

Leesburg, VA 201755113

Telephone 7037778777
Fax 7037776901
Associated Practice Facility / Clinic
🏢 Douglas Herbert, D.d.s., Ltd. Facility NPI 1720124977

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Leesburg, VA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 14.6 Yrs
Regional Practice Density
42 Specialists

Practicing in Leesburg, VA (3535 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-07-07
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License VA 0401008551

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Blue Cross Blue Shield
452873 (VA)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
Dr. Amanda Brown , DDS

Dentist - General Practice

NPI 1710188560

Doctor of Dental Surgery

Dr. Carol Yacoub , DDS

Dentist - General Practice

NPI 1811549272

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location July 07, 2025

Registered at 1614 VILLAGE MARKET BLVD SE STE 100, LEESBURG, VA 201755113 (Tel: 7037778777)

📍
Updated Business Mailing Address July 07, 2025

Registered at 1614 VILLAGE MARKET BLVD SE STE 100, LEESBURG, VA 201755113 (Tel: 7037778777)

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 555 GROVE ST STE 108, HERNDON, VA 201704728 (Tel: 7037877778)

📍
Updated Business Mailing Address July 08, 2007

Registered at 555 GROVE ST STE 108, HERNDON, VA 201704728 (Tel: 7037877778)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as WALTER COLLAZO, D.D.S.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #0401008551 in VA)

🟢
Initial NPI Registration & Enumeration October 13, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1780774299
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 13, 2006
Last Update: July 07, 2025
Sole Proprietor: Yes

Mailing Address

1614 Village Market Blvd Se Ste 100

Leesburg, VA 201755113

Phone: 7037778777

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.