Gaurav Pravinchandra Modi

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019.037316 Issued in IL

Practice address

1174 W Maple Ave
Mundelein, IL 60060-1438

Phone

(847) 305-4700

NPI assigned

Jul 15, 2026

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Om Family Dental PLLC

  • General Practice Dentistry
  • Mundelein, IL
  • NPI 1740938000
  NPD (past)

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

{
    "created_epoch": "1784073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784073600000",
    "number": "1215856992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "272 LE PARC CIR",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600896903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1174 W MAPLE AVE",
            "city": "MUNDELEIN",
            "state": "IL",
            "postal_code": "600601438",
            "telephone_number": "847-305-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODI",
        "first_name": "GAURAV",
        "middle_name": "PRAVINCHANDRA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-07-15",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.037316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Constance Meloney, LMT
• Melissa Yvette Mendoza, RDN, LDN
• Mercyland Residential
• Meridian Regional Imaging,LLC
• Merry Walker Corporation
• Beth Dalton Moffitt, CCC-SLP
• Sarah Morosan-Vanderheyden, PSYD, LCP
• Maryann Morse, APN
• Katie Mucia, FNP-BC
• Sindhuja Muddam

• General Practice Dentistry in Mundelein, IL
• Providers in Mundelein, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2026; 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.