Leesburg Modern Dentistry, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

LEESBURG MODERN DENTISTRY, PC

Practice address

502 E Market St
Leesburg, VA 20176-4112

Phone

(571) 899-4713

Fax

(571) 982-7616

NPI assigned

Aug 15, 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) 899-4713

Specialties & licenses 1

Addresses

Other names 1

• Leesburg 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.

• Shahad Amoori

  • General Practice Dentistry
  • Leesburg, VA
  • NPI 1336982263
  NPD
• Seokhoon Lee, DDS

  • General Practice Dentistry
  • Leesburg, VA
  • NPI 1689343105
  NPD

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

{
    "created_epoch": "1660521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660521600000",
    "number": "1932837101",
    "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": "502 E MARKET ST",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201764112",
            "telephone_number": "571-899-4713",
            "fax_number": "571-982-7616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEESBURG MODERN DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-15",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A",
        "authorized_official_last_name": "SHAHRESTANI",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "OWNER DOCTOR",
        "authorized_official_telephone_number": "571-899-4713",
        "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": "Leesburg Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Leesburg Dental Office PLLC
• Leesburg Dental P C
• Leesburg Family Eyecare
• Leesburg Life Care, LLC
• Leesburg Life Care, LLC
• Leesburg Optometry, LLC
• Leesburg Premier Dental
• Leesburg Sports, Inc.
• Legacy Dialysis of Virginia
• Legacy Orthodontics, PLC

• General Practice Dentistry in Leesburg, VA
• Providers in Leesburg, 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 Aug 15, 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.