Ian E Modestow, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

20017 Issued in MA

Practice address

190 Nonotuck St
Suite 103
Florence, MA 01062-1911

Phone

(413) 586-5887

Fax

(413) 586-5978

NPI assigned

Jan 23, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1053381178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 NONOTUCK ST",
            "address_2": "SUITE 103",
            "city": "FLORENCE",
            "state": "MA",
            "postal_code": "010621911",
            "telephone_number": "413-586-5887",
            "fax_number": "413-586-5978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 NONOTUCK ST",
            "address_2": "SUITE 103",
            "city": "FLORENCE",
            "state": "MA",
            "postal_code": "010621911",
            "telephone_number": "413-586-5887",
            "fax_number": "413-586-5978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODESTOW",
        "first_name": "IAN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "20017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MA DENTAL LICENSE",
            "identifier": "20017",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MA",
            "identifier": "X11346",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Scott R Meyers, PSY.D.
• Melissa Michalski, MS
• Virginia L Miller, CNM
• Mary E Mitchell
• Modestow Family Dentistry PC
• Katherine Moeller, LICSW
• Abigail Moore, MSW, LICSW
• Chloe Helene Mortelliti, RDN
• Susan J. Mosler, MD
• Fuad B Mudawwar, MD

• General Practice Dentistry in Florence, MA
• Providers in Florence, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.