Stephen P Fassnacht, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5338 Issued in VA

Practice address

8500 Executive Park Ave Ste 208
Fairfax, VA 22031-2253

Phone

(703) 400-3675

NPI assigned

Oct 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Mar 15, 2016 through Mar 15, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Burke Family Dentistry PC

  • General Practice Dentistry
  • Burke, VA
  • NPI 1558928135
  NPD (past)
• Lifetime Smiles Burke

  • Dental Clinic/Center
  • Burke, VA
  • NPI 1316473937
  NPD (past)

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581033600000",
    "number": "1194815399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10236 FAIRE COMMONS CT",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "220152857",
            "telephone_number": "703-400-3675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8500 EXECUTIVE PARK AVE STE 208",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220312253",
            "telephone_number": "703-400-3675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASSNACHT",
        "first_name": "STEPHEN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "5338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Farrell
• Allie Farris, ED.S.
• Christian Fary
• Tara Fasanello, COTA/L
• Fasika Waldearegay MD PLLC
• Fast Trans LLC
• Andrea J. Fata, LPC
• Monica Anahita Fathipour Jalilian
• Kaneez Fatima
• Fatina Smith, LCSW, LLC

• General Practice Dentistry in Fairfax, VA
• Providers in Fairfax, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.