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General NPI Number Information
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NPI Number | 1578496162
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Entity Type | Individual
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Provider Name | SANDRA EVANA SANSANO MAGNANI DDS
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Gender | Female
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Dates
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Enumeration Date | 06/04/2026
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Last Update Date | 06/04/2026
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Provider Practice Location Address
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Address Line | 10529 CRESTWOOD DR STE 103
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City | MANASSAS
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State | VA
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Zip | 20109-4419
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Country | US
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Telephone | 703-393-9393
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Fax |
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Provider Business Mailing Address
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Address Line | 2902 MAINSTONE DR
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City | FAIRFAX
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State | VA
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Zip | 22031-1421
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0401418388
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License Number State | VA
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