Fair Lakes Family and Cosmetic Dentistry

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401410709 Issued in VA

Legal business name

FAIR LAKES FAMILY AND COSMETIC DENTISTRY

Practice address

12110 Monument Dr Ste a
Fairfax, VA 22033-5553

Phone

(703) 273-4505

Fax

(703) 273-5757

NPI assigned

Mar 5, 2012

Last updated

Mar 5, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Annah P Tran, DDSNPI 1912110115

Title

Dentist, President

Phone

(703) 273-4505

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Annah P Tran, DDS

  • Dentist
  • Fairfax, VA
  • NPI 1912110115
  NPD (past) Authorized official
• Jennifer T Nguyen, DMD

  • Dentist
  • Fairfax, VA
  • NPI 1881988988
  NPD (past)

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

{
    "created_epoch": "1330905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330905600000",
    "number": "1427322734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12110 MONUMENT DR STE A",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220335553",
            "telephone_number": "703-273-4505",
            "fax_number": "703-273-5757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12110 MONUMENT DR STE A",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220335553",
            "telephone_number": "703-273-4505",
            "fax_number": "703-273-5757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIR LAKES FAMILY AND COSMETIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-05",
        "last_updated": "2012-03-05",
        "status": "A",
        "authorized_official_last_name": "TRAN",
        "authorized_official_first_name": "ANNAH",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "DENTIST, PRESIDENT",
        "authorized_official_telephone_number": "703-273-4505",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401410709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Faeder, FNP
• Katie Fago
• Emily Fagre, LCSW
• Maria Lucille Fain, CRNA
• Fair Lakes Dental
• Fair Lakes Optometry
• Fair Oaks Emergency Physicians, PLLC
• Fair Oaks Hospitalist Physicians, PLLC
• Fair Oaks Imaging Center, PC
• Fair Oaks Internal Medicine

• 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 Mar 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.