Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Bluemont Plastic Surgery, PC

Organization Otolaryngology Physician · NPI 1023405297

Bluemont Plastic Surgery, PC is an Otolaryngology Physician in Fairfax, Virginia. Licensed in Virginia. Registered with an NPI since 2015.

Licensed in
VA
In the registry since
2015
Specialties on file
3
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

8316 Arlington Blvd Ste 524
Fairfax, VA 22031-5216
Phone: (703) 596-1660
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Plastic and Reconstructive Surgery Physician (primary) Taxonomy 2086S0122X
Otolaryngology Physician Taxonomy 207Y00000X · Licence 0101257764 (VA)
Plastic Surgery Physician Taxonomy 208200000X · Licence 0101257764 (VA)

Record details

NPI number1023405297
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mark Domanski — President · (703) 596-1660
NPI enumeratedApril 24, 2015
Last updated in NPPESJuly 18, 2023
Certification dateJuly 18, 2023
Mailing address8316 Arlington Blvd Ste 524, Fairfax, VA 22031-5216

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