Modern American Dental Clinic PC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

MODERN AMERICAN DENTAL CLINIC PC

Practice address

14350 W Warren
Dearborn, MI 48126

Phone

(313) 582-1919

Fax

(313) 582-0300

NPI assigned

Oct 11, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Nabil Berry, DENTIST DDS

Title

Dentist Owner

Phone

(313) 582-1919

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454025600000",
    "number": "1164510129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14350 W WARREN",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "48126",
            "telephone_number": "313-582-1919",
            "fax_number": "313-582-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14350 W WARREN",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "48126",
            "telephone_number": "313-582-1919",
            "fax_number": "313-582-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN AMERICAN DENTAL CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2016-01-29",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "NABIL",
        "authorized_official_title_or_position": "DENTIST OWNER",
        "authorized_official_telephone_number": "313-582-1919",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DENTIST DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4773148",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "D15159MI",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mobile Eye Care, LLC
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• Melissa Daria Moccia-Patton, D.D.S.
• Romulo M Mocorro Jr., CRNA
• Modern American Dental Clinic P. C.
• Modern Physical Therapy & Rehab, Inc.
• Modern Psychiatry PC
• Miranda Mae Moffat
• Leslie Marie Mofrad, RN , MSN, CPNP
• Meagan Mogalli

• Dentist in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2016; 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.