# FAIR LAKES DENTAL

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1548493885
- **Authorized official:** JOSEPH DEHYAR D.M.D. (OWNER)
- **Authorized official phone:** (703) 764-0650

## Contact information

- **Practice address:** 12989 FAIR LAKES PKWY, FAIRFAX, VA 22033
- **Practice address phone:** (703) 222-1230
- **Mailing address:** 9534 BURKE ROAD, BURKE, VA 22015
- **Mailing address phone:** (703) 764-0650
- **Mailing address fax:** (703) 764-1772

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 0401411034 | VA | Yes |

## Other

- **Enumeration date:** 09/03/2009
- **Last updated:** 09/03/2009