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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

NICKIE ROSE BASTANI, DDS

Active

NICKIE ROSE BASTANI, DDS is a Pediatric Dentistry healthcare provider located in FAIRFAX, Virginia. NPI 1801140892 is currently active in the NPPES registry. Verify at CMS.

Pediatric Dentistry · FAIRFAX, VA

Registration Details

NPI Number
1801140892
Provider Type
Individual
Gender
Female
NPI Issued
Oct 30, 2012 (13.801800510997 yrs)
Last Updated
Jan 21, 2021
Licenses
2901020839 (MI)
2901020839 (MI)

Practice Information

Address
3700 JOSEPH SIEWICK DR STE 104
FAIRFAX, VA, 220331737
Browse VA providers · Browse ZIP 22033
Phone
7036209122
Primary Specialty
Pediatric Dentistry
1223P0221X
Additional Specialty
Pediatric Dentistry

Other Pediatric Dentistry Providers in FAIRFAX, VA

Name Credential NPI
JOHN HAN D.D.S. 1780781351
DR. FARANAK GHALEHBAGHI DDS 1821308115
SHOHREH SHARIF D.D.S. P.C. 1144523218
BUSHRA A BHATTI DMD, MSD 1538448683
HEIDI OSTRENG VATANKA DDS 1043585995
DR. JAZMIN TYSHEEMAH FLOYD DMD 1780950287
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.