Shane R. Costa DDS, PC

General Practice Dentistry · Great Falls, VA

Organization Active NPI

NPI number 1740476993

Practice location

10135 Colvin Run Rd
Suite 230
Great Falls, VA 22066-1872
Phone
(804) 690-2042

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NPI record

NPI
1740476993
Entity type
Organization (Type 2)
Enumeration date
September 21, 2007
Last updated
September 21, 2007
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X 0401410911 VA

Authorized official

Name
Dr. Shane1 Ryan Costa, D.D.S.
Title
Owner
Phone
(804) 690-2042

About Shane R. Costa DDS, PC

Shane R. Costa DDS, PC is a healthcare organization registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 10135 Colvin Run Rd, Suite 230, Great Falls, VA 22066-1872. The NPI number 1740476993 was assigned on September 21, 2007 and the record was last updated on September 21, 2007.

Shane R. Costa DDS, PC 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.

The authorized official for this organization is Dr. Shane1 Ryan Costa, D.D.S., Owner.

Frequently asked questions

What is the NPI number of Shane R. Costa DDS, PC?

The NPI number is 1740476993.

What is the phone number of Shane R. Costa DDS, PC?

The phone number listed for the practice location is (804) 690-2042.

Where is Shane R. Costa DDS, PC located?

10135 Colvin Run Rd, Suite 230, Great Falls, VA 22066-1872.

What is the taxonomy code for Shane R. Costa DDS, PC?

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.

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