Fair Oaks Skin Care Center, LTD

Primary specialty

SpecialistTaxonomy code 174400000X

License

0101046760 Issued in VA

Legal business name

FAIR OAKS SKIN CARE CENTER, LTD

Doing business as

Fair Oaks Skin Care Center

Practice address

3700 Joseph Siewick Dr
Suite 403
Fairfax, VA 22033-1744

Phone

(703) 648-2488

Fax

(703) 648-2489

NPI assigned

Feb 26, 2007

Last updated

Aug 22, 2020By 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. Brenda Dintiman, M.D.

Title

President

Phone

(703) 648-2488

Specialties & licenses 1

Addresses

Other names 1

• FAIR OAKS SKIN CARE CENTER Doing business as

Locations

Practitioners 3

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.

• Rolla Jaber, M.D.

  • Dermatology Physician
  • Fairfax, VA
  • NPI 1174724876
  NPD (past)
• Mary Katherine Mather, MD

  • Dermatology Physician
  • Dumfries, VA
  • NPI 1508964529
  NPD (past)
• Tammy L Hay, D.O.

  • Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
  • Charlotte, NC
  • NPI 1154374387
  NPD (past)

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831225507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 JOSEPH SIEWICK DR",
            "address_2": "SUITE 403",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220331744",
            "telephone_number": "703-648-2488",
            "fax_number": "703-648-2489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 JOSEPH SIEWICK DR",
            "address_2": "SUITE 403",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220331744",
            "telephone_number": "703-648-2488",
            "fax_number": "703-648-2489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIR OAKS SKIN CARE CENTER, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DINTIMAN",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-648-2488",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101046760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAIR OAKS SKIN CARE CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Fair Oaks Ortho, PLLC
• Fair Oaks Ortho, PLLC
• Fair Oaks Orthopaedic Associates, Inc
• Fair Oaks Podiatry and Sports
• Fair Oaks Podiatry and Sports
• Fair Oaks Smiles Pediatric Dentistry
• Fair Oaks SNF Operations LLC (Fair Oaks Health & Rehabilitation)
• Fair Oaks Surgical Associates LLC
• Fair Oaks Urology, L.L.C.
• Fair Oaks Womens Center

• Specialist in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Specialist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.