Individual provider Active NPI

Adrian Ryczak

  • General Practice Dentistry
  • Fairfax, VA
National Provider Identifier
1275446114
Registry record updated Sep 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401420269 Issued in VA
Practice address
3930 Walnut St Ste 240
Fairfax, VA 22030-4738
Phone
(703) 638-1420
NPI assigned
Sep 23, 2026
Last updated
Sep 23, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 0401420269 VA Primary

Addresses

Primary practice location

3930 Walnut St Ste 240
Fairfax, VA 22030-4738

Mailing address

615 Swann Ave Apt 430
Alexandria, VA 22301-1461
Phone (856) 952-0165

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790121600000",
    "number": "1275446114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 SWANN AVE APT 430",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223011461",
            "telephone_number": "856-952-0165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3930 WALNUT ST STE 240",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220304738",
            "telephone_number": "703-638-1420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYCZAK",
        "first_name": "ADRIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-09-23",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401420269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.