Luxe Dermatology and Aesthetic Center, PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

LUXE DERMATOLOGY AND AESTHETIC CENTER, PLLC

Practice address

8200 Greensboro Dr Ste 801
MC Lean, VA 22102-4925

Phone

(703) 942-9787

Fax

(703) 563-3824

NPI assigned

Apr 16, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Liza Moore, MDNPI 1730405010

Title

Owner

Phone

(919) 274-4199

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Liza Alexandra Moore, MD

  • Dermatology Physician
  • MC Lean, VA
  • NPI 1730405010

  DC, Single Specialty

  Medicare reassignment Care Compare group NPD Authorized official
• Reem Tadros, M.D.

  • Specialist
  • Fairfax, VA
  • NPI 1205934213

  DC

  Medicare reassignment Care Compare group NPD
• Suzannah Kawachi, PA-C

  • Medical Physician Assistant
  • MC Lean, VA
  • NPI 1457194201

  DC

  Medicare reassignment Care Compare group
• Christine Ember Lienau, PHYSICIAN ASSISTANT

  • Medical Physician Assistant
  • MC Lean, VA
  • NPI 1235731183

  DC

  Medicare reassignment Care Compare group

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1555372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583971200000",
    "number": "1174186100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8200 GREENSBORO DR STE 801",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221024925",
            "telephone_number": "703-942-9787",
            "fax_number": "703-563-3824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 GREENSBORO DR STE 801",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221024925",
            "telephone_number": "703-942-9787",
            "fax_number": "703-563-3824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUXE DERMATOLOGY AND AESTHETIC CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-16",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "LIZA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-274-4199",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Minh Duc Luong, OD
• Mark Luposello, D.M.D.
• Dorcas Worley Lushetsky, LCSW
• Brandon Lusk, PT, DPT
• Jessica Elizabeth Lussier, BSW
• Luxottica of America Inc
• Luxottica of America Inc.
• Luxure Medical Beauty Institute
• Lync Health PC
• Beverly Holstun Lynch, LCSW

• Dermatology Physician in MC Lean, VA
• Providers in MC Lean, VA by specialty
• Dermatology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.