Provider Demographics
NPI:1417258955
Name:SHAHREYAR SEAN SAYYAR,DDS,PC
Entity Type:Organization
Organization Name:SHAHREYAR SEAN SAYYAR,DDS,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST /OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAHREYAR
Authorized Official - Middle Name:S
Authorized Official - Last Name:SAYYAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:804-290-8001
Mailing Address - Street 1:5231 HICKORY PARK DR
Mailing Address - Street 2:SUITE E
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-2619
Mailing Address - Country:US
Mailing Address - Phone:804-290-8001
Mailing Address - Fax:804-290-8005
Practice Address - Street 1:5231 HICKORY PARK DR
Practice Address - Street 2:SUITE E
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23059
Practice Address - Country:US
Practice Address - Phone:804-290-8001
Practice Address - Fax:804-290-8005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-16
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401008883122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty