Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dental Family Practice

Organization General Practice Dentistry · NPI 1558483305

Dental Family Practice is a General Practice Dentistry in Lake Ridge, Virginia. Licensed in Virginia. Registered with an NPI since 2007.

Licensed in
VA
In the registry since
2007
Specialties on file
3

Practice location Address checks out

12724 Directors Loop
Lake Ridge, VA 22192-2462
Phone: (703) 494-9171
Fax: (703) 490-4066
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 0401007810 (VA)
Periodontics Taxonomy 1223P0300X · Licence 0401008961 (VA)
Orthodontics and Dentofacial Orthopedics Dentistry Taxonomy 1223X0400X · Licence 0401410790 (VA)

Record details

NPI number1558483305
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mina Mostofi — Dentist · (703) 494-9171
Other names Lake Ridge Dental Clinic
NPI enumeratedApril 4, 2007
Last updated in NPPESJune 23, 2008
Mailing address12724 Directors Loop, Lake Ridge, VA 22192-2462

Other providers in Lake Ridge