# BRISTOW FOUNTAIN DENTISTRY, PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bristow Fountain Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447818919
- **Authorized official:** DR. ALEX R SHARIFIAN DDS (OWNER/GENERAL DENTIST)
- **Authorized official phone:** (703) 565-2920

## Contact information

- **Practice address:** 10283 BRISTOW CENTER DR, BRISTOW, VA 20136-2240
- **Practice address phone:** (703) 565-2920
- **Mailing address:** 17000 RED HILL AVE, IRVINE, CA 92614-5626

## Taxonomy

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

## Other

- **Enumeration date:** 05/30/2019
- **Last updated:** 05/30/2019