Organization
CHANTILLY MODERN DENTISTRY, PC
Active
Other names
Chantilly Modern Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALEX R SHARIFIAN DDS (OWNER/DDS)
(703) 214-2113
Entity
Organization
Contact information
Practice address
14337 NEWBROOK DR., SUITE 200, CHANTILLY, VA 20151
(703) 214-2113
Mailing address
PO BOX 920050, DALLAS, TX 75392-0050
(714) 845-8280
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
04/26/2018
Last updated
08/05/2022
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