Modern Dental Center Stevens Point LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

MODERN DENTAL CENTER STEVENS POINT LLC

Practice address

5541 US Highway 10 E
Stevens Point, WI 54482-8306

Phone

(715) 344-7911

NPI assigned

Feb 25, 2022

Last updated

Jul 21, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Victoria Johnson

Title

Cro

Phone

(941) 444-0558

Specialties & licenses 1

Addresses

Other names 1

• Dental Care Alliance Other name

Locations

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

{
    "created_epoch": "1645747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784592000000",
    "number": "1275289472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5541 US HIGHWAY 10 E",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "544828306",
            "telephone_number": "715-344-7911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5541 US HIGHWAY 10 E",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "544828306",
            "telephone_number": "715-344-7911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN DENTAL CENTER STEVENS POINT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-25",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "CRO",
        "authorized_official_telephone_number": "941-444-0558"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Care Alliance",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Dentist in Stevens Point, WI
• Providers in Stevens Point, WI by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.