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

Kaelan Dendy Young Black, MD

Individual provider Pediatric Otolaryngology Physician · NPI 1215226469

Kaelan Dendy Young Black, MD is an Otolaryngology in Fairfax, Virginia. Graduated from Georgetown University School of Medicine in 2011, 15 years ago. Practices with Otolaryngology Associates PC, a 31-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Oregon and Virginia.

Years since qualifying
15
Trained at
Georgetown University School of Medicine
Licensed in
OR, VA
In the registry since
2011
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

3801 University Dr Ste 300
Fairfax, VA 22030-2503
Phone: (703) 383-8130
Fax: (703) 383-7350
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 501 N Graham St Ste 585, Portland, OR 97227-1654 — (503) 413-3690

Specialties & licences

Pediatric Otolaryngology Physician (primary) Taxonomy 207YP0228X · Licence 0101263011 (VA)
Pediatric Otolaryngology Physician Taxonomy 207YP0228X · Licence MD223309 (OR)

Record details

NPI number1215226469
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 28, 2011
Last updated in NPPESAugust 29, 2025
Certification dateAugust 29, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOTOLARYNGOLOGY
Medical schoolGEORGETOWN UNIVERSITY SCHOOL OF MEDICINE
Graduated 2011 (15 years in practice)
Group practice Otolaryngology Associates Pc — 31 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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