OrganizationActive
Lake Wylie Modern Dentistry, PC
NPI 1194376491 · Dentist · Lake Wylie, SC
Lake Wylie Modern Dentistry, PC is a Dentist organization in Lake Wylie, SC (NPI 1194376491).
Provider details
- NPI number
- 1194376491
- Entity type
- Organization
- Primary specialty
- DentistDental Providers
- Organization subpart
- No
- Authorized official
- Ali Shahrestani, Owner(803) 752-0565
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(65/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
140 Highway 274
Lake Wylie, SC 29710-6045
Phone: (803) 752-0565
Street-level locationGet directions
Mailing address
Po Box 920050
Dallas, TX 75392-0050
Other names (DBA / former)
- Doing business as
- Lake Wylie Modern Dentistry
- Doing business as
- Lake Wylie Modern Dentistry
Registry dates
- Enumerated
- 2019-09-27
- Last updated
- 2022-06-14
- Certified
- 2022-06-14
Frequently asked questions
- What is Lake Wylie Modern Dentistry, PC's NPI number?
- Lake Wylie Modern Dentistry, PC's National Provider Identifier (NPI) is 1194376491, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Lake Wylie Modern Dentistry, PC?
- Lake Wylie Modern Dentistry, PC is classified in the NPPES registry as Dentist (Dental Providers).
- Where is Lake Wylie Modern Dentistry, PC located?
- Lake Wylie Modern Dentistry, PC's practice location on file with NPPES is 140 Highway 274, Lake Wylie, SC 29710-6045.
- What is Lake Wylie Modern Dentistry, PC's phone number?
- The practice phone number listed in the NPPES registry for Lake Wylie Modern Dentistry, PC is (803) 752-0565.
- Who is the authorized official for Lake Wylie Modern Dentistry, PC?
- The authorized official listed on Lake Wylie Modern Dentistry, PC's NPPES record is Ali Shahrestani, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Lake Wylie Modern Dentistry, PC's NPI active?
- Yes — Lake Wylie Modern Dentistry, PC's NPI (1194376491) is active in the NPPES registry as of the last update on 2022-06-14.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.