Modern Smiles PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MODERN SMILES PLLC

Doing business as

Modern Smiles

Practice address

2933 W Cactus Rd
Phoenix, AZ 85029-2346

Phone

(602) 863-9079

NPI assigned

Jan 8, 2024

Organization subpart

No

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

Authorized official

Name

Chad Hendricks

Title

Credentialing

Phone

(612) 859-0444

Specialties & licenses 1

Addresses

Other names 1

• Modern Smiles Doing business as

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

{
    "created_epoch": "1704672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704672000000",
    "number": "1164292256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2933 W CACTUS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850292346",
            "telephone_number": "602-863-9079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2933 W CACTUS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850292346",
            "telephone_number": "602-863-9079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN SMILES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-08",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A",
        "authorized_official_last_name": "HENDRICKS",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "612-859-0444"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Modern Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Modern Dental Professionals Az PC (Bright Now Dental)
• Modern Healthcare, Inc
• Modern Interventional Radiology, LLC
• Modern Recovery, Inc. (Virgil- Phoenix)
• Modern Sight Eyecare PLLC
• Modern Sports Medicine LLC
• Modern Tinnitus LLC
• Modest Dentistry LLC
• Amanda Modesta Keyhani, MD
• Bhavan Modi, MD

• General Practice Dentistry in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2024; 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.