NPIMap

Organization Active NPI

Fairfax Oral and Maxillofacial Surgery PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Fairfax, VA
National Provider Identifier
1710907134
Registry record updated Apr 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
FAIRFAX ORAL AND MAXILLOFACIAL SURGERY PC
Practice address
10530 Rosehaven St
Suite 111
Fairfax, VA 22030-2840
Phone
(703) 385-5777
Fax
(703) 591-5386
NPI assigned
Jul 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2009

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

Authorized official

Name
Julia M Spradlin
Title
Administrator
Phone
(703) 385-5777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X Primary

Addresses

Primary practice location

10530 Rosehaven St
Suite 111
Fairfax, VA 22030-2840

Mailing address

10530 Rosehaven St
Suite 111
Fairfax, VA 22030-2840
Phone (703) 385-5777

National Provider Directory

National Provider Directory

Locations

10530 Rosehaven St
Ste 111
Fairfax, VA 22030
Phone (703) 352-1493

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240790400000",
    "number": "1710907134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10530 ROSEHAVEN ST",
            "address_2": "SUITE 111",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302840",
            "telephone_number": "703-385-5777",
            "fax_number": "703-591-5386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10530 ROSEHAVEN ST",
            "address_2": "SUITE 111",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302840",
            "telephone_number": "703-385-5777",
            "fax_number": "703-591-5386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRFAX ORAL AND MAXILLOFACIAL SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2009-04-27",
        "status": "A",
        "authorized_official_last_name": "SPRADLIN",
        "authorized_official_first_name": "JULIA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "703-385-5777"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "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 Apr 27, 2009; 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.