Springfield Modern Dentistry, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SPRINGFIELD MODERN DENTISTRY, PC

Practice address

8404 Old Keene Mill Rd
Springfield, VA 22152-2302

Phone

(571) 350-3556

Fax

(571) 290-4715

NPI assigned

Sep 12, 2022

Organization subpart

No

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

Authorized official

Name

Ali Shahrestani, DMD

Title

Owner Doctor

Phone

(571) 350-3556

Specialties & licenses 1

Addresses

Other names 1

• Springfield Modern Dentistry Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Duy-Kha Tran Thai, DMD

  • Dentist
  • Springfield, VA
  • NPI 1184304057
  NPD
• Mustafa Zaeean, DDS

  • Dentist
  • Springfield, VA
  • NPI 1235065129
  NPD (past)

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

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662940800000",
    "number": "1396467965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920050",
            "telephone_number": "714-845-8890",
            "fax_number": "303-952-0892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8404 OLD KEENE MILL RD",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221522302",
            "telephone_number": "571-350-3556",
            "fax_number": "571-290-4715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRINGFIELD MODERN DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-12",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A",
        "authorized_official_last_name": "SHAHRESTANI",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "OWNER DOCTOR",
        "authorized_official_telephone_number": "571-350-3556",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Springfield Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Springfield Foot & Ankle Center, LTD.
• Springfield Healthy Smile
• Springfield Healthy Smiles
• Springfield Mall Optical, Inc.
• Springfield Medical Clinic
• Springfield Oral Surgery, PC
• Springfield Orthodontic Associates, PLLC
• Springfield Pediatric Associates, LTD, P.C.
• Springfield Primary and Walk in Clinic Inc
• Springfield Supp Ctr Inc

• General Practice Dentistry in Springfield, VA
• Providers in Springfield, 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 Sep 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.