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

Nickie Rose Bastani, DDS

Individual provider General Practice Dentistry · NPI 1801140892

Nickie Rose Bastani, DDS is a General Practice Dentistry in Fairfax, Virginia. Works from 2 locations. Licensed in Michigan.

Licensed in
MI
In the registry since
2012
Specialties on file
2
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

3700 Joseph Siewick Dr Ste 104
Fairfax, VA 22033-1737
Phone: (703) 620-9122
Show map & directions

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

Additional practice locations (1)

  • 1011 N University Ave, Ann Arbor, MI 48109-1078 — (734) 764-1522

Specialties & licences

Pediatric Dentistry (primary) Taxonomy 1223P0221X · Licence 2901020839 (MI)
General Practice Dentistry Taxonomy 1223G0001X · Licence 2901020839 (MI)

Record details

NPI number1801140892
Entity typeIndividual (Type 1)
GenderFemale
Credentials DDS
Sole proprietorNo
NPI enumeratedOctober 30, 2012
Last updated in NPPESJanuary 21, 2021
Certification dateJanuary 5, 2021

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