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

Renascance Dermatology PC

Organization Dermatology Physician · NPI 1457796641

Renascance Dermatology PC is a Dermatology Physician in Fairfax, Virginia. Licensed in Virginia. Registered with an NPI since 2013.

Licensed in
VA
In the registry since
2013
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

3620 Joseph Siewick Dr Ste 303
Fairfax, VA 22033-1756
Phone: (703) 865-6783
Fax: (703) 865-6784
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 0101240235 (VA)

Record details

NPI number1457796641
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Dwana Shabazz — Owner · (703) 865-6783
NPI enumeratedMay 1, 2013
Last updated in NPPESMay 1, 2013
Mailing address3620 Joseph Siewick Dr, Suite 303, Fairfax, VA 22033-1756

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