MEDICARE: RIDGETOP DENTAL OF STERLING, 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	122300000X	Dentist

General Provider Information

NPI Number	:	1699381913
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIDGETOP DENTAL OF STERLING, PLLC

Provider Business Mailing Address
First Line	:	21631 RIDGETOP CIR STE 240
Second Line	:
City	:	STERLING
State	:	VA
Zip	:	20166-4288
Country	:	US
Telephone Number	:	703-444-9900
Fax Number	:

Provider Business Practice Location Address
First Line	:	21631 RIDGETOP CIR STE 240
Second Line	:
City	:	STERLING
State	:	VA
Zip	:	20166-4288
Country	:	US
Telephone Number	:	703-444-9900
Fax Number	:

Authorized Official
Title or Position	:	DENTIST/OWNER
Name	:	DIANA SENSENBRENNER
Credential	:	DDS
Telephone Number	:	703-444-9900

Provider Enumeration Date	:	09/22/2020
Last Update Date	:	09/22/2020

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