Organization
FAIR OAKS SMILES PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAISA REINA (OM)
(703) 986-8456
Entity
Organization
Contact information
Practice address
4001 FAIR RIDGE DR STE 205, FAIRFAX, VA 22033-2917
(703) 589-9962
(703) 831-3773
Mailing address
4001 FAIR RIDGE DR STE 205, FAIRFAX, VA 22033-2917
(703) 589-9962
(703) 831-3773
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
01/28/2026
Last updated
01/28/2026
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