Active NPI
Brian Christopher Modrowski, DDS
- General Practice Dentistry
- Fort Collins, CO
National Provider Identifier
1053535302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 8353
- Practice address
- 2021 Battlecreek Dr
Suite C
Fort Collins, CO 80528-5119 - Phone
- (970) 229-0099
- Fax
- (970) 229-1879
- NPI assigned
- Apr 11, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 8353 | CO | Primary |
Addresses
Primary practice location
2021 Battlecreek Dr
Suite C
Fort Collins, CO 80528-5119
Mailing address
2021 Battlecreek Dr
Suite C
Fort Collins, CO 80528-5119
Phone (970) 229-0099
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Oct 24, 2016 through Oct 24, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8353 | CO | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peak Family Dental Inc. | General Practice | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Fort Collins, CO
- NPI 1609899038
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053535302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2021 BATTLECREEK DR",
"address_2": "SUITE C",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805285119",
"telephone_number": "970-229-0099",
"fax_number": "970-229-1879"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2021 BATTLECREEK DR",
"address_2": "SUITE C",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805285119",
"telephone_number": "970-229-0099",
"fax_number": "970-229-1879"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MODROWSKI",
"first_name": "BRIAN",
"middle_name": "CHRISTOPHER",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CO",
"license": "8353",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Collins, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.