Justin Modugno, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

30-024466 Issued in OH

Practice address

8340 Cleveland Ave NW
North Canton, OH 44720-4820

Phone

(330) 494-6305

NPI assigned

Jun 30, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Cleveland Clinic Mercy Hospital

  • General Acute Care Hospital
  • Canton, OH
  • NPI 1366433195
  Medicare reassignment NPD
• Cleveland Clinic Mercy Hospital

  • Dental Clinic/Center
  • Canton, OH
  • NPI 1023362100
  NPD

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

{
    "created_epoch": "1435622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1346623147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8340 CLEVELAND AVE NW",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447204820",
            "telephone_number": "330-494-6305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8340 CLEVELAND AVE NW",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447204820",
            "telephone_number": "330-494-6305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODUGNO",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-30",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "RES.3620",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30-024466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth C Mitchell Sr., SLP
• Madison Mitchell
• Amanda Mitchely, LPTA
• Breanna Mize
• Michael Mocarski, LPTA
• Paula J Moffat, COTA/L
• Kelley Moffett, MSW, LSW
• Angela T Mohler, COTA/L
• Storm Allen Mohn, DDS
• Jill Mohr, COTA/L

• Dentist in North Canton, OH
• Providers in North Canton, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.