Provider Demographics
NPI:1508390386
Name:DENTIST OF STERLING PC
Entity Type:Organization
Organization Name:DENTIST OF STERLING PC
Other - Org Name:DENTISTS OF STERLING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAHRESTANI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:703-454-0560
Mailing Address - Street 1:17000 RED HILL AVE
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-5626
Mailing Address - Country:US
Mailing Address - Phone:714-845-8500
Mailing Address - Fax:703-774-3521
Practice Address - Street 1:21435 EPICERIE PLZ STE 190
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20164-6641
Practice Address - Country:US
Practice Address - Phone:703-454-0560
Practice Address - Fax:703-774-3521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-18
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty