Shane Ryan Costa, D.D.S

General Practice Dentistry · Reston, VA

Individual Active NPI

NPI number 1407889306

Practice location

1950 Roland Clarke Pl
Suite 450
Reston, VA 20191-1414
Phone
(703) 391-2600
Fax
(703) 391-2097

Open in Google Maps

NPI record

NPI
1407889306
Entity type
Individual (Type 1)
Enumeration date
July 7, 2006
Last updated
July 8, 2007
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X 0401410911 VA

Mailing address

1626 Apricot Ct
Reston, VA 20190-4404
Phone
(703) 956-9097
Fax
(703) 391-2097

About Dr. Costa

Shane Ryan Costa, D.D.S is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 1950 Roland Clarke Pl, Suite 450, Reston, VA 20191-1414. The NPI number 1407889306 was assigned on July 7, 2006 and the record was last updated on July 8, 2007.

Dr. Costa lists a license in the registry: #0401410911 (VA) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Shane Ryan Costa, D.D.S?

The NPI number is 1407889306.

What is the phone number of Dr. Costa?

The phone number listed for the practice location is (703) 391-2600.

Where is Dr. Costa located?

1950 Roland Clarke Pl, Suite 450, Reston, VA 20191-1414.

What is the taxonomy code for Dr. Costa?

The primary taxonomy code is 1223G0001X – General Practice Dentistry.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

Other General Practice Dentistry providers in Reston

All General Practice Dentistry providers in Reston, VA →