# MANASSAS MODERN DENTISTRY PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Manassas Modern Dentistry PLLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114652286
- **Authorized official:** DR. TAREQ SALAMEH DDS (DOCTOR/OWNER)
- **Authorized official phone:** (561) 827-1164

## Contact information

- **Practice address:** 10620 CRESTWOOD DR STE A, MANASSAS, VA 20109-4403
- **Practice address phone:** (703) 361-2911
- **Mailing address:** 10620 CRESTWOOD DR STE A, MANASSAS, VA 20109-4403
- **Mailing address phone:** (703) 361-2911

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 07/21/2022
- **Last updated:** 05/11/2023