RENASCANCE DERMATOLOGY PC (NPI# 1457796641) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457796641 |
| Entity Type | Organization |
| Organization Name | RENASCANCE DERMATOLOGY PC |
| Practice Address |
3620 Joseph Siewick Dr Suite 303 Fairfax VA 22033-1756 |
| Practice Telephone | 7038656783 |
| Practice Fax Number | 7038656784 |
| Mailing Telephone | 7038656783 |
| Mailing Fax Number | 7038656784 |
| Enumeration Date | 2013-05-01 |
| Last Update Date | 2013-05-01 |
| Authorized Official Name | DR. DWANA RASHAD SHABAZZ (OWNER) |
| Authorized Official Telephone | 7038656783 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 0101240235 | VA | Allopathic & Osteopathic Physicians |
| Street Address |
3620 JOSEPH SIEWICK DR SUITE 303 |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22033-1756 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689671414 | Adil Zahoor Ghauri | Internal Medicine | 3620 Joseph Siewick Dr, 306, Fairfax, VA 22033-1756 | 2005-07-07 |
| 1144878190 | Nicolas Gay | Physical Therapist | 3620 Joseph Siewick Dr, Suite 201, Fairfax, VA 22033-1758 | 2019-09-03 |
| 1164938247 | Han Thi Ngoc Nguyen | Nurse Practitioner | 3620 Joseph Siewick Dr, Ste 406, Fairfax, VA 22033-1761 | 2017-12-27 |
| 1265885107 | Allison Elizabeth Simons | Physical Therapist | 3620 Joseph Siewick Dr, Suite 106, Fairfax, VA 22033-1756 | 2016-07-15 |
| 1710345525 | Paola Andrea Garcia Veizaga | Physical Therapist | 3620 Joseph Siewick Dr, Fairfax, VA 22033-1756 | 2016-02-08 |
| 1427436062 | Maria Tadic | Dietitian, Registered | 3620 Joseph Siewick Dr, Suite 200, Fairfax, VA 22033-1756 | 2015-05-15 |
| 1780078030 | Gretta Herbert | Specialist | 3620 Joseph Siewick Dr, Suite 307, Fairfax, VA 22033-1756 | 2015-03-25 |
| 1356734412 | Northern Virginia Surgery Center Anesthesia | Anesthesiology | 3620 Joseph Siewick Dr, Suite 202, Fairfax, VA 22033-1756 | 2015-03-13 |
| 1396137956 | Sarah Margerison | Physical Therapist | 3620 Joseph Siewick Dr, Suite 100-a, Fairfax, VA 22033-1756 | 2015-02-19 |
| 1962749374 | Andrew David Elkins | Physician Assistant | 3620 Joseph Siewick Dr, Ste 100, Fairfax, VA 22033-1757 | 2013-01-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366074320 | Han S Yoo | Pharmacist | 12200 West Ox Road, Fairfax, VA 22033 | 2020-02-07 |
| 1386137271 | Ammar Orthodontics Pllc | Dentist | 11702 Fiar Oaks Mall, Upper Floor, Fairfax, VA 22033 | 2018-06-14 |
| 1013360940 | Kellyn Patricia Dodd | Nurse Practitioner | 3903 Fair Ridge Dr Ste 209, Fairfax, VA 22033 | 2016-07-15 |
| 1659721363 | John Du Od PC | Optometrist | 12618 Victoria Station Ct, Fairfax, VA 22033 | 2016-06-14 |
| 1568861904 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 12734 Shoppes Lane, Fairfax, VA 22033 | 2014-08-21 |
| 1649696295 | Patrisha Lultschik | Nurse Practitioner | 12375 Lee Jackson Memorial Hwy, Fairfax, VA 22033 | 2014-03-06 |
| 1912321910 | Alyson Huber | Nurse Anesthetist, Certified Registered | 3600 Joseph Siewick Dr., Fairfax, VA 22033 | 2014-02-11 |
| 1578999314 | Aiatulah Surmaty | Optometrist | 11801 Lee Jackson Memorial Hwy, Fairfax, VA 22033 | 2013-09-25 |
| 1356780928 | Ayatallah M. Khafagy | Obstetrics & Gynecology | 3650 Joseph Siewick Dr Suite 203, Fairfax, VA 22033 | 2013-06-17 |
| 1760726665 | Michelle Elise Schwartz | Speech-Language Pathologist | 3507 Curtice Farm Dr, Fairfax, VA 22033 | 2012-11-15 |
| Find all providers in zip 22033 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174901953 | Amanda Unalivia | Dermatology | 3700 Joseph Siewick Dr Ste 302, Fairfax, VA 22033-1739 | 2015-05-12 |
| 1134516271 | Kathleen Ellison | Dermatology | 8316 Arlington Blvd Ste 400, Fairfax, VA 22031-5216 | 2015-04-15 |
| 1508276619 | Charles Martin Aaronson | Dermatology | 3606 Lido Pl., Fairfax, VA 22031 | 2014-04-29 |
| 1740359017 | Moses K Albert | Dermatology | 3025 Hamaker Ct Ste 300, Fairfax, VA 22031-2237 | 2006-11-08 |
| 1205212933 | Dermatology of Virginia | Dermatology | 3930 Pender Dr, Suite 210, Fairfax, VA 22030-0985 | 2015-08-04 |
| 1861890303 | Integrated Dermatology of Fairfax, LLC | Dermatology | 10721 Main St Ste 200, Fairfax, VA 22030-6913 | 2014-12-16 |
| 1497173512 | Michele Zerah Magnino | Dermatology | 3025 Hamaker Ct Ste 300, Fairfax, VA 22031-2237 | 2014-04-05 |
| 1093158461 | Monica Nabil Saleh Valentin | Dermatology | 11351 Random Hills Rd, Fairfax, VA 22030 | 2013-04-16 |
| 1245404276 | Carol L Piatt, Md, PC | Dermatology | 8301 Arlington Blvd, Suite 501, Fairfax, VA 22031-2902 | 2008-04-22 |
| 1255501417 | Moses K Albert Md PC | Dermatology | 3020 Hamaker Ct, Fairfax, VA 22031-2238 | 2008-03-04 |
| Find all providers in FAIRFAX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.