Healthcare Provider Details

I. General information

NPI: 1790797793
Provider Name (Legal Business Name): SINA JOHN SABET MD, FACS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2006
Last Update Date: 08/13/2025
Certification Date: 07/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5130 DUKE ST SUITE #9
ALEXANDRIA VA
22304-2906
US

IV. Provider business mailing address

5130 DUKE ST SUITE #9
ALEXANDRIA VA
22304-2906
US

V. Phone/Fax

Practice location:
  • Phone: 703-370-9411
  • Fax: 571-431-6778
Mailing address:
  • Phone: 703-370-9411
  • Fax: 571-431-6778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberD89540
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberMD037775
License Number StateDC
# 3
Primary TaxonomyY
Taxonomy Code207WX0009X
TaxonomyGlaucoma Specialist (Ophthalmology) Physician
License Number0101056974
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number0101056974
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: