OrganizationActive
Keith J Wilson DDS PC
NPI 1154447589 · General Practice Dentistry · Fairfax, VA
Keith J Wilson DDS PC is a General Practice Dentistry organization in Fairfax, VA (NPI 1154447589).
Provider details
- NPI number
- 1154447589
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Keith Wilson, Owner President(703) 691-3015
- License
- 0401008681 (VA)
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
11166 Fairfax Blvd Ste 400
Fairfax, VA 22030-5017
Phone: (703) 691-3015
Fax: (703) 691-3016
Street-level locationGet directions
Mailing address
11166 Fairfax Blvd Ste 400
Fairfax, VA 22030-5017
Other names (DBA / former)
- Doing business as
- Fair Lakes Dental Services
Registry dates
- Enumerated
- 2007-03-21
- Last updated
- 2020-08-22
Frequently asked questions
- What is Keith J Wilson DDS PC's NPI number?
- Keith J Wilson DDS PC's National Provider Identifier (NPI) is 1154447589, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Keith J Wilson DDS PC?
- Keith J Wilson DDS PC is classified in the NPPES registry as General Practice Dentistry (Dental Providers).
- Where is Keith J Wilson DDS PC located?
- Keith J Wilson DDS PC's practice location on file with NPPES is 11166 Fairfax Blvd Ste 400, Fairfax, VA 22030-5017.
- What is Keith J Wilson DDS PC's phone number?
- The practice phone number listed in the NPPES registry for Keith J Wilson DDS PC is (703) 691-3015.
- Who is the authorized official for Keith J Wilson DDS PC?
- The authorized official listed on Keith J Wilson DDS PC's NPPES record is Keith Wilson, Owner President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Keith J Wilson DDS PC's NPI active?
- Yes — Keith J Wilson DDS PC's NPI (1154447589) is active in the NPPES registry as of the last update on 2020-08-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.