Tysons Modern Dentistry, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

TYSONS MODERN DENTISTRY, PC

Practice address

8393 Leesburg Pike
Vienna, VA 22182-2402

Phone

(703) 745-1797

NPI assigned

Feb 25, 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

Title

Owner

Phone

(714) 845-8500

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Shaina Rachel Wasser, DDS

  • General Practice Dentistry
  • Vienna, VA
  • NPI 1063153260
  NPD

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

{
    "created_epoch": "1645747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645747200000",
    "number": "1508512708",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8393 LEESBURG PIKE",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822402",
            "telephone_number": "703-745-1797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TYSONS MODERN DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-25",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A",
        "authorized_official_last_name": "SHAHRESTANI",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-845-8500"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tysons Corner Ophthalmic Associates, LTD
• Tysons Corner Opticians Inc
• Tysons Dental Spa
• Tysons Gynecology and Menopause Center LLC
• Tysons Medical Group
• Tysons Pharmacy Inc
• Tysons Therapeutics PLLC
• Oganya Anita Udenyi, PHD, RD, LDN
• Ufirst Planners LLC
• Christina G. Ulen, MD

• General Practice Dentistry in Vienna, VA
• Providers in Vienna, 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 Feb 25, 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.