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General NPI Number Information
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NPI Number | 1063612406
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Entity Type | Organization
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Legal Business Name | SHAHROKH SOLTANI DMD PC
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Dates
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Enumeration Date | 07/24/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 21495 RIDGETOP CIRCLE SUITE 100
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City | STERLING
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State | VA
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Zip | 20166
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Country | US
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Telephone | 703-406-8600
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Fax | 703-406-8601
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Provider Business Mailing Address
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Address Line | 21495 RIDGETOP CIRCLE SUITE 100
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City | STERLING
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State | VA
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Zip | 20166
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Country | US
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Telephone | 703-406-8600
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Fax | 703-406-8601
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | SHAHROKH SOLTANI
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Credential |
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Telephone | 703-406-8600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State | VA
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