Mina Modaresi DDS PC

Primary specialty

DentistTaxonomy code 122300000X

License

0401410066 Issued in VA

Legal business name

MINA MODARESI DDS PC

Practice address

45985 Regal PLZ
Suite 160
Sterling, VA 20165-6144

Phone

(703) 433-1122

Fax

(703) 433-0907

NPI assigned

Oct 5, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Mina Modaresi, DDSNPI 1073626818

Title

President

Phone

(703) 433-1122

Specialties & licenses 1

Addresses

Other names 1

• Regal Dental Care Doing business as

Locations

Practitioners 1

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

• Mina Modaresi, DDS

  • General Practice Dentistry
  • Sterling, VA
  • NPI 1073626818
  NPD (past) Authorized official

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

{
    "created_epoch": "1317772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317772800000",
    "number": "1851675185",
    "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": {
        "organization_name": "MINA MODARESI DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-05",
        "last_updated": "2011-10-05",
        "status": "A",
        "authorized_official_last_name": "MODARESI",
        "authorized_official_first_name": "MINA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-433-1122",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401410066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Regal Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• John Michael Miller, L.C.S.W
• Keysha Miller, MSW
• Christopher Millikan, PT
• Rebecca Min
• Mina Dadkhah DDS, PLLC
• Anshul Misra
• Mitnick & Herbst, PC
• Howard M Mitnick Jr., DDS
• MJ 247 Care Services LLC
• Mina Modaresi, DDS

• Dentist in Sterling, VA
• Providers in Sterling, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2011; 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.