| Reston Dental Group, PC | |
|
11107 Sunset Hills Rd Ste 111 Reston VA 20190-5481 | |
| (703) 860-3200 | |
| (703) 391-8228 |
| Full Name | Reston Dental Group, PC |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 11107 Sunset Hills Rd Ste 111, Reston, Virginia |
| Authorized Official Name and Position | Carol Lynn Mohammed (BUSINESS MANAGER) |
| Authorized Official Contact | 7038603200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Reston Dental Group, PC 11107 Sunset Hills Rd Ste 111 Reston VA 20190-5481 Ph: (703) 860-3200 | Reston Dental Group, PC 11107 Sunset Hills Rd Ste 111 Reston VA 20190-5481 Ph: (703) 860-3200 |
| NPI Number | 1427128669 |
|---|---|
| Provider Enumeration Date | 11/08/2006 |
| Last Update Date | 04/13/2022 |
| Certification Date | 04/13/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427128669 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (Virginia) | Primary |
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