Individual
KAELAN DENDY YOUNG BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3801 UNIVERSITY DR STE 300, FAIRFAX, VA 22030-2503
(703) 383-8130
(703) 383-7350
Mailing address
3801 UNIVERSITY DR, STE 200, FAIRFAX, VA 22030-2503
(703) 383-8130
(703) 383-7353
Taxonomy
Speciality
Code
Description
License number
State
207YP0228X
Pediatric Otolaryngology Physician
Primary
0101263011
VA
207YP0228X
Pediatric Otolaryngology Physician
MD223309
OR
Other
Enumeration date
03/28/2011
Last updated
08/29/2025
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