# FAIRFAX CITY DENTIST, PLC

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

## Provider details

- **NPI number:** 1265369946
- **Authorized official:** DR. VLADYSLAV OVCHARENKO (OWNER)
- **Authorized official phone:** (703) 385-1617

## Contact information

- **Practice address:** 3929 BLENHEIM BLVD STE 91D, FAIRFAX, VA 22030-2421
- **Practice address phone:** (703) 385-1617
- **Practice address fax:** (703) 865-7711
- **Mailing address:** 3929 BLENHEIM BLVD STE 91D, FAIRFAX, VA 22030-2421
- **Mailing address phone:** (703) 385-1617
- **Mailing address fax:** (703) 865-7711

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 05/06/2026
- **Last updated:** 05/06/2026