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

Lake Wylie Modern Dentistry, PC

Organization Dentist · NPI 1194376491

Lake Wylie Modern Dentistry, PC is a Dentist in Lake Wylie, South Carolina. Registered with an NPI since 2019.

In the registry since
2019
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

140 Highway 274
Lake Wylie, SC 29710-6045
Phone: (803) 752-0565
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X

Record details

NPI number1194376491
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ali Shahrestani — Owner · (803) 752-0565
Other names Lake Wylie Modern Dentistry; Lake Wylie Modern Dentistry
NPI enumeratedSeptember 27, 2019
Last updated in NPPESJune 14, 2022
Certification dateJune 14, 2022
Mailing addressPo Box 920050, Dallas, TX 75392-0050

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