Mina Modaresi, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401410066 Issued in VA

Practice address

45985 Regal PLZ
Suite 160
Sterling, VA 20165-6144

Phone

(703) 433-1122

Fax

(703) 433-0907

NPI assigned

Aug 16, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Modaresi & Avin DDS PLLC

  • General Practice Dentistry
  • Chantilly, VA
  • NPI 1477160547
  NPD Authorized official
• Mina Modaresi DDS PC

  • Dentist
  • Sterling, VA
  • NPI 1851675185
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073626818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45985 REGAL PLZ",
            "address_2": "SUITE 160",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201656144",
            "telephone_number": "703-433-1122",
            "fax_number": "703-433-0907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45985 REGAL PLZ",
            "address_2": "SUITE 160",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201656144",
            "telephone_number": "703-433-1122",
            "fax_number": "703-433-0907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODARESI",
        "first_name": "MINA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401410066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mina Modaresi DDS PC
• Anshul Misra
• Mitnick & Herbst, PC
• Howard M Mitnick Jr., DDS
• MJ 247 Care Services LLC
• Mancy Modi
• Siddhant Modi
• Lindsay Moffatt
• Sheeba Mohanan, OD
• Michelle Moinifar, O.D.

• General Practice Dentistry in Sterling, VA
• Providers in Sterling, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.