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SERGIO FABIAN CALLEJA BLANCO DDS
NPI 1255824371
Dentist - Oral and Maxillofacial Surgery in Annandale, VA

Active since June 13, 2018Opted out of Medicare · through Feb 1, 2028
7611 LITTLE RIVER TPKE STE 101E, ANNANDALE, VA 22003(703) 634-4195 Get Directions Write a Review

NPPES record last updated: April 7, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 7, 2025, Jun 25, 2024, Jun 13, 2018 (3 updates tracked since 2018).

About Sergio Fabian Calleja Blanco Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SERGIO FABIAN CALLEJA BLANCO DDS (NPI 1255824371) is an individual oral and maxillofacial surgery provider in Annandale, Virginia, licensed in Michigan (2901022647) and active in the NPI registry since June 2018. He has opted out of Medicare through February 1, 2028.

NPPES Registry Identity

NPI1255824371
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameSERGIO FABIAN CALLEJA BLANCOCredential: DDS
Location Address7611 LITTLE RIVER TPKE STE 101EAnnandale, VA 22003-2630
Mailing Address325 W Lake Lansing RdEast Lansing, MI 48823-8524 · (734) 353-1251 · Fax (517) 337-9759
Phone(703) 634-4195
Sole ProprietorYes
Enumeration DateJune 13, 2018
Last NPPES UpdateApril 7, 20253 updates tracked since enumeration
NPPES CertifiedApril 7, 2025
✔ NPI 1255824371 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in MI · 2901022647
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Also ListedDentistTaxonomy 122300000X · License 2901022647 (MI)
7611 LITTLE RIVER TPKE STE 101E, Annandale, VA 22003
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

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Opted out of Medicare

Sergio Fabian Calleja Blanco Dds has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from February 1, 2026 through February 1, 2028.

Opt-Out Effective DateFebruary 1, 2026
Opt-Out In Effect ThroughFebruary 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. OLUWOLE OLUBUNMI FADAHUNSI DMD
Dentist (Oral and Maxillofacial Surgery)
7611 LITTLE RIVER TPKE STE 101E
ANNANDALE, VA 22003
Fairfax County (703) 634-4195
DR. IRELSY ALEXANDRA RIVERA VELAZQUEZ DMD, MSD
Dentist (Oral and Maxillofacial Surgery)
7611 LITTLE RIVER TPKE STE 101E
ANNANDALE, VA 22003
Fairfax County (787) 949-5828
CAMERON TAYLOR DAHLQUIST DDS
Dentist (Oral and Maxillofacial Surgery)
7611 LITTLE RIVER TPKE STE 101E
ANNANDALE, VA 22003
Fairfax County (703) 650-0638

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sergio Calleja Blanco's NPI number?

The NPI number for Sergio Calleja Blanco is 1255824371. It was assigned to this individual provider in the NPPES registry on June 13, 2018.

Where is Sergio Calleja Blanco located?

Sergio Calleja Blanco practices at 7611 Little River Tpke Ste 101E, Annandale, VA 22003. The listed phone number is (703) 634-4195.

What is Sergio Calleja Blanco's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Sergio Calleja Blanco enrolled in Medicare?

No. Sergio Calleja Blanco has opted out of Medicare through February 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

What insurance does Sergio Calleja Blanco accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 4 other insurers list Sergio Calleja Blanco as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Sergio Calleja Blanco was last updated on April 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.