Fairfax Modern Dentistry, PC

NPI #1174011191 in Fairfax, Virginia

Provider Information

NPI Number: 1174011191
Entity Type: Organization
Organization Name: Fairfax Modern Dentistry, PC
Primary Specialty: Dentist
Enumeration Date: Apr 25, 2018
Last Updated: Aug 5, 2022

Practice Location

Address: 11050 LEE HWY
City: Fairfax
State: Virginia
ZIP Code: 22030-5014
Phone: (703) 520-6376

Authorized Official

Name: DR. ALI SHAHRESTANI, DMD
Title: OWNER/DMD
Phone: (703) 520-6376

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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