# MCLEAN DERMATOLOGY AND SKINCARE CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255645776
- **Authorized official:** LILY TALAKOUB (OWNER)
- **Authorized official phone:** (703) 356-5111

## Contact information

- **Practice address:** 6849 OLD DOMINION DR STE 450, MC LEAN, VA 22101-3718
- **Practice address phone:** (703) 356-5111
- **Practice address fax:** (703) 388-0873
- **Mailing address:** PO BOX 9143, MC LEAN, VA 22102-0143
- **Mailing address phone:** (703) 356-5111
- **Mailing address fax:** (703) 388-0873

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 01012445533 | VA | Yes |

## Other

- **Enumeration date:** 07/27/2010
- **Last updated:** 07/02/2026