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

Konstantin Sergeyevich Gutnichenko

Individual provider Surgical Assistant · NPI 1538847348

Konstantin Sergeyevich Gutnichenko is a Surgical Assistant in Fairfax, Virginia. Practices as a sole proprietor. Licensed in Virginia.

Licensed in
VA
In the registry since
2023

Practice location Address checks out

12011 Lee Jackson Hwy Ste 501
Fairfax, VA 22033-3315
Phone: (703) 259-7027
Show map & directions

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

Specialties & licences

Surgical Assistant (primary) Taxonomy 246ZC0007X · Licence 0136000798 (VA)

Record details

NPI number1538847348
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJuly 11, 2023
Last updated in NPPESJuly 11, 2023
Certification dateJuly 11, 2023
Mailing addressPo Box 221135, Chantilly, VA 20153-1135

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