Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jackson Ariel Moscoso, SURGICALASSISTANT

Individual provider Surgical Assistant · NPI 1720625080

Jackson Ariel Moscoso, SURGICALASSISTANT is a Surgical Assistant in Fairfax, Virginia. Practices as a sole proprietor. Licensed in Virginia.

Licensed in
VA
In the registry since
2019
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Practice location Address checks out

3127 Plantation Pkwy
Fairfax, VA 22030-2117
Phone: (571) 594-8144
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Assistant (primary) Taxonomy 246ZC0007X · Licence 5092 (VA)

Record details

NPI number1720625080
Entity typeIndividual (Type 1)
GenderMale
Credentials SURGICALASSISTANT
Sole proprietorYes
NPI enumeratedDecember 5, 2019
Last updated in NPPESDecember 31, 2019
Certification dateDecember 31, 2019

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