# SOUTH RIDING MODERN DENTISTRY, PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** South Riding Modern Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982178620
- **Authorized official:** DR. ALEX R SHARIFIAN DDS (OWNER/DDS)
- **Authorized official phone:** (703) 543-9724

## Contact information

- **Practice address:** 25421 LIZZIO CENTER DR., SUITE 190, CHANTILLY, VA 20152
- **Practice address phone:** (703) 543-3724
- **Mailing address:** 17000 RED HILL AVE, IRVINE, CA 92614-5626
- **Mailing address phone:** (714) 845-8500
- **Mailing address fax:** (303) 952-0892

## Taxonomy

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

## Other

- **Enumeration date:** 01/16/2019
- **Last updated:** 01/16/2019