Healthcare Provider Details

I. General information

NPI: 1477494110
Provider Name (Legal Business Name): MCLEAN DENTAL LOFT PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2026
Last Update Date: 04/06/2026
Certification Date: 04/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6715 WHITTIER AVE STE 300
MC LEAN VA
22101-4502
US

IV. Provider business mailing address

6715 WHITTIER AVE STE 300
MC LEAN VA
22101-4502
US

V. Phone/Fax

Practice location:
  • Phone: 703-343-0504
  • Fax:
Mailing address:
  • Phone: 703-343-0504
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. ARDALAN SANATI
Title or Position: PRESIDENT
Credential: DDS
Phone: 703-343-0504