MEDICARE: MCLEAN DENTAL LOFT PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1477494110
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MCLEAN DENTAL LOFT PLLC

Provider Business Mailing Address
First Line	:	6715 WHITTIER AVE STE 300
Second Line	:
City	:	MC LEAN
State	:	VA
Zip	:	22101-4502
Country	:	US
Telephone Number	:	703-343-0504
Fax Number	:

Provider Business Practice Location Address
First Line	:	6715 WHITTIER AVE STE 300
Second Line	:
City	:	MC LEAN
State	:	VA
Zip	:	22101-4502
Country	:	US
Telephone Number	:	703-343-0504
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ARDALAN SANATI
Credential	:	DDS
Telephone Number	:	703-343-0504

Provider Enumeration Date	:	04/06/2026
Last Update Date	:	04/06/2026

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