Modern Dental Center

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

MODERN DENTAL CENTER

Practice address

4608 Lower Roswell Rd
Marietta, GA 30068-4237

Phone

(770) 615-6510

Fax

(770) 615-6511

NPI assigned

May 8, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Marianna Kovitch, DMDNPI 1407141864

Title

Dentist/Owner

Phone

(770) 615-6510

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marianna Libkind Kovitch, DMD

  • Dentist
  • Marietta, GA
  • NPI 1407141864
  NPD Authorized official

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

{
    "created_epoch": "1715126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727222400000",
    "number": "1093563751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4608 LOWER ROSWELL RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300684237",
            "telephone_number": "770-615-6510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4608 LOWER ROSWELL RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300684237",
            "telephone_number": "770-615-6510",
            "fax_number": "770-615-6511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-08",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A",
        "authorized_official_last_name": "KOVITCH",
        "authorized_official_first_name": "MARIANNA",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "770-615-6510",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• MMH Professional Counseling LLC
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• Arden Constance Mobley, OTR/L
• Irina Mocanu, NP
• Gayatree Sant Modak
• Karishma Modi, DC
• Milan Modi, DC
• Mitra Mofid, M.D.
• Mohammad a. Khan, M.D. LLC
• Fabeeha Mohammad, DO

• Customized Equipment (DME) in Marietta, GA
• Providers in Marietta, GA by specialty
• Customized Equipment (DME) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.