Organization Active NPI

Fair Oaks Smiles Pediatric Dentistry

  • Pediatric Dentistry
  • Fairfax, VA
National Provider Identifier
1508716838
Registry record updated Jan 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
FAIR OAKS SMILES PEDIATRIC DENTISTRY
Practice address
4001 Fair Ridge Dr Ste 205
Fairfax, VA 22033-2917
Phone
(703) 589-9962
Fax
(703) 831-3773
NPI assigned
Jan 28, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2026

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

Authorized official

Name
Raisa Reina
Title
Om
Phone
(703) 986-8456

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

4001 Fair Ridge Dr Ste 205
Fairfax, VA 22033-2917

Mailing address

4001 Fair Ridge Dr Ste 205
Fairfax, VA 22033-2917
Phone (703) 589-9962

National Provider Directory

National Provider Directory

Locations

4001 Fair Ridge Dr
Ste 205
Fairfax, VA 22033
Phone (703) 273-8479

Practitioners & affiliated clinicians

Practitioners 1

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": "1769558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769558400000",
    "number": "1508716838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 FAIR RIDGE DR STE 205",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332917",
            "telephone_number": "703-589-9962",
            "fax_number": "703-831-3773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 FAIR RIDGE DR STE 205",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332917",
            "telephone_number": "703-589-9962",
            "fax_number": "703-831-3773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIR OAKS SMILES PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-28",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A",
        "authorized_official_last_name": "REINA",
        "authorized_official_first_name": "RAISA",
        "authorized_official_title_or_position": "OM",
        "authorized_official_telephone_number": "703-986-8456"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "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 Jan 28, 2026; 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.