Healthcare Provider Details

I. General information

NPI: 1568306660
Provider Name (Legal Business Name): FOX FAMILY DENTISTRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2026
Last Update Date: 04/17/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5200 LYNGATE CT
BURKE VA
22015
US

IV. Provider business mailing address

5200 LYNGATE CT
BURKE VA
22015
US

V. Phone/Fax

Practice location:
  • Phone: 703-978-5253
  • Fax: 703-978-1624
Mailing address:
  • Phone: 703-978-5253
  • Fax: 703-978-1624

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: MR. LAWEENCE T FOX
Title or Position: OWNER
Credential: DDS
Phone: 703-978-5253