Active NPI
McLean Dermatology and Skincare Center
- Medical Specialty Clinic/Center
- MC Lean, VA
National Provider Identifier
1255645776
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Specialty Clinic/Center
- License
- 01012445533
- Legal business name
- MCLEAN DERMATOLOGY AND SKINCARE CENTER
- Practice address
- 6849 Old Dominion Dr Ste 450
MC Lean, VA 22101-3718 - Phone
- (703) 356-5111
- Fax
- (703) 388-0873
- NPI assigned
- Jul 27, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lily Talakoub
- Title
- Owner
- Phone
- (703) 356-5111
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Specialty Clinic/Center | 261QM2500X | 01012445533 | VA | Primary |
Addresses
Primary practice location
6849 Old Dominion Dr Ste 450
MC Lean, VA 22101-3718
Mailing address
PO Box 9143
MC Lean, VA 22102-0143
Phone (703) 356-5111
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
6849 Old Dominion Dr
Ste 450
McLean, VA 22101
Phone (703) 356-5111
Practitioners & affiliated clinicians
Practitioners 9
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280188800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1782950400000",
"number": "1255645776",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9143",
"city": "MC LEAN",
"state": "VA",
"postal_code": "221020143",
"telephone_number": "703-356-5111",
"fax_number": "703-388-0873"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6849 OLD DOMINION DR STE 450",
"city": "MC LEAN",
"state": "VA",
"postal_code": "221013718",
"telephone_number": "703-356-5111",
"fax_number": "703-388-0873"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MCLEAN DERMATOLOGY AND SKINCARE CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2010-07-27",
"last_updated": "2026-07-02",
"certification_date": "2026-07-02",
"status": "A",
"authorized_official_last_name": "TALAKOUB",
"authorized_official_first_name": "LILY",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "703-356-5111"
},
"taxonomies": [
{
"code": "261QM2500X",
"taxonomy_group": "",
"desc": "Clinic/Center, Medical Specialty",
"state": "VA",
"license": "01012445533",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in MC Lean, VA
- Grace Rebecca McLaurin
- McLean Ambulatory Surgery, LLC
- McLean Behavioral Health
- McLean Chiropractic, Rehab and Massage Center LLC
- McLean Dental Loft PLLC
- McLean Medical Center and Urgent Care LLC
- McLean Neuropsychiatric Treatment Center LLC
- McLean Optometry, LLC
- McLean Oral & Maxillofacial Surgery
- McLean Pharmacy Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.