Ali Istarabadi
Individual provider Active NPI Dentist · Tysons, VA
NPI 1760169841 · NPPES record last updated Jun 21, 2025
Key facts
- NPI
- 1760169841
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 04014119330 (VA)
- Practice address
- 8310 Old Courthouse Rd
Tysons, VA 22182-3872 - Phone
- (571) 773-6582
- NPI assigned
- Jun 30, 2023
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04014119330 | VA | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dentist | 122300000X | 04014119330 | VA | Yes |
Addresses
Primary practice location
8310 Old Courthouse Rd
Tysons, VA 22182-3872
Mailing address
622 W 168TH St
New York, NY 10032-3720
Phone (434) 446-7292
Other practice location 1
622 W 168th St
New York, NY 10032-3720
Phone (434) 446-7292
Other providers in Tysons, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 21, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.