NPIMap

Organization Active NPI

Modern Dental

  • General Practice Dentistry
  • El Campo, TX
National Provider Identifier
1114586161
Registry record updated Jun 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MODERN DENTAL
Practice address
3604 West Loop Unit A2
El Campo, TX 77437-8029
Phone
(979) 320-8000
Fax
(832) 437-8754
NPI assigned
Jun 12, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2019

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

Authorized official

Name
Gagandeep Kahlon, DDS
Title
Owner
Phone
(979) 320-8000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

3604 West Loop Unit A2
El Campo, TX 77437-8029

Mailing address

3604 West Loop Unit A2
El Campo, TX 77437-8029
Phone (979) 320-8000

National Provider Directory

National Provider Directory

Locations

3604 West Loop
Unit A2
El Campo, TX 77437
Phone (979) 320-8000

NPI Registry JSON

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

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560297600000",
    "number": "1114586161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3604 WEST LOOP UNIT A2",
            "city": "EL CAMPO",
            "state": "TX",
            "postal_code": "774378029",
            "telephone_number": "979-320-8000",
            "fax_number": "832-437-8754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3604 WEST LOOP UNIT A2",
            "city": "EL CAMPO",
            "state": "TX",
            "postal_code": "774378029",
            "telephone_number": "979-320-8000",
            "fax_number": "832-437-8754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-12",
        "last_updated": "2019-06-12",
        "status": "A",
        "authorized_official_last_name": "KAHLON",
        "authorized_official_first_name": "GAGANDEEP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "979-320-8000",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Campo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2019; 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.