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PREMIER DENTAL GROUP PLLC
NPI 1063971281
Dentist - Pediatric Dentistry in Manassas, VA

Active since March 18, 2019
9420 FORESTWOOD LN STE 201, MANASSAS, VA 20110(617) 943-8812 Get Directions Write a Review

NPPES record last updated: March 18, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Premier Dental Group Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PREMIER DENTAL GROUP PLLC (NPI 1063971281), doing business as Lighthouse Pediatric Dental Team, is a healthcare organization registered as a pediatric dentistry in Manassas, Virginia and active in the NPI registry since March 2019. The organization lists Payam Amirsayafi, Owner, as its authorized official.

NPPES Registry Identity

NPI1063971281
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NamePREMIER DENTAL GROUP PLLC
Location Address9420 FORESTWOOD LN STE 201Manassas, VA 20110-4758
Mailing Address9420 Forestwood Ln Ste 201Manassas, VA 20110-4758
Phone(617) 943-8812
Organization SubpartNo
Authorized OfficialPayam AmirsayafiOwner · (617) 943-8812
Enumeration DateMarch 18, 2019
✔ NPI 1063971281 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Also ListedDentist · Dentist AnesthesiologistTaxonomy 1223D0004X
9420 FORESTWOOD LN STE 201, Manassas, VA 20110
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Other Names 1

Doing Business AsLighthouse Pediatric Dental Team

Other Identifiers 1

Medicaid1881968204VA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Humana, UnitedHealthcare.Insurance ›

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALI ZAMANI DDS
Dentist (Pediatric Dentistry)
9420 FORESTWOOD LN STE 201
MANASSAS, VA 20110
Manassas City (571) 390-6100

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Premier Dental Group PLLC's NPI number?

The NPI number for Premier Dental Group PLLC is 1063971281. It was assigned to this organization in the NPPES registry on March 18, 2019. The provider is doing business as Lighthouse Pediatric Dental Team.

Where is Premier Dental Group PLLC located?

Premier Dental Group PLLC is located at 9420 Forestwood Ln Ste 201, Manassas, VA 20110. The listed phone number is (617) 943-8812.

What is Premier Dental Group PLLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

What insurance does Premier Dental Group PLLC accept?

Health plans from Humana and UnitedHealthcare list Premier Dental Group PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Premier Dental Group PLLC was last updated on March 18, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.