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Dr. Shane Ryan Costa, DDS
General Practice Dentistry in Reston, Virginia
NPI 1407889306

Shane Ryan Costa is a General Practice Dentistry based in Reston, VA and is specialized in General Practice. Shane Ryan Costa practices in Reston, VA and has the professional credentials of DDS. The NPI Number for Shane Ryan Costa is 1407889306 and holds a License No. 0401410911 (Virginia).

The current practice location address for Shane Ryan Costa is 1950 Roland Clarke Pl, Reston, VA and can be reached out via phone at 703-391-2600 and via fax at 703-391-2097.

Location: 1950 Roland Clarke Pl, Reston, VA, 20190-4404
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1407889306
Provider Name
Shane Ryan Costa
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
1950 Roland Clarke Pl, Reston, VA, 20190-4404
Phone Number
703-391-2600
Fax Number
703-391-2097
Provider Enumeration Date
07/07/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
1950 Roland Clarke Pl
City
Reston
State
Virginia
Zip
20191-1414
Phone Number
703-391-2600
Fax Number
703-391-2097
person
Provider Business Mailing Address Details
Address
1950 Roland Clarke Pl
City
Reston
State
Virginia
Zip
20191-1414
Phone Number
703-391-2600
Fax Number
703-391-2097
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
0401410911 (Virginia)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
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