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NICKIE ROSE BASTANI DDS
NPI 1801140892
Dentist - Pediatric Dentistry in Fairfax, VA

Active since October 30, 2012
3700 JOSEPH SIEWICK DR STE 104, FAIRFAX, VA 22033(703) 620-9122 Get Directions Write a Review

NPPES record last updated: January 21, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Nickie Rose Bastani Dds NPPES

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

NICKIE ROSE BASTANI DDS (NPI 1801140892) is an individual pediatric dentistry provider in Fairfax, Virginia, licensed in Michigan (2901020839) and active in the NPI registry since October 2012. She maintains a secondary practice location in Ann Arbor.

NPPES Registry Identity

NPI1801140892
Entity TypeIndividualFemale
Primary Taxonomy1223P0221X
Provider Legal NameNICKIE ROSE BASTANICredential: DDS
Location Address3700 JOSEPH SIEWICK DR STE 104Fairfax, VA 22033-1737
Mailing Address1363 Tate Modern LaneGreat Falls, VA 22066 · (571) 426-8274
Phone(703) 620-9122
Sole ProprietorNo
Enumeration DateOctober 30, 2012
Last NPPES UpdateJanuary 21, 2021
NPPES CertifiedJanuary 5, 2021
✔ NPI 1801140892 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
License✔ Licensed in MI · 2901020839
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 · General PracticeTaxonomy 1223G0001X · License 2901020839 (MI)
3700 JOSEPH SIEWICK DR STE 104, Fairfax, VA 22033
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Secondary Practice Location 1

Location 11011 N University AveAnn Arbor, MI 48109-1078 · Phone (734) 764-1522 · Fax (734) 763-8100

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana and more.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.

DR. SUEPHIE NAZEMIAN
Dentist
3700 JOSEPH SIEWICK DR STE 104
FAIRFAX, VA 22033
Fairfax County (703) 620-9122

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 Nickie Bastani's NPI number?

The NPI number for Nickie Bastani is 1801140892. It was assigned to this individual provider in the NPPES registry on October 30, 2012.

Where is Nickie Bastani located?

Nickie Bastani practices at 3700 Joseph Siewick Dr Ste 104, Fairfax, VA 22033. The listed phone number is (703) 620-9122.

What is Nickie Bastani's specialty?

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

What insurance does Nickie Bastani accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 6 other insurers list Nickie Bastani 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 Nickie Bastani was last updated on January 21, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.