Healthcare Provider Details

I. General information

NPI: 1891626099
Provider Name (Legal Business Name): DIAMANTI MICHAEL BATISTAS DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24565 DULLES LANDING DR UNIT 190
STERLING VA
20166-2714
US

IV. Provider business mailing address

7982 VALDERRAMA CT
GAINESVILLE VA
20155-2825
US

V. Phone/Fax

Practice location:
  • Phone: 703-621-4751
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number0401420018
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: