NPIMap

Organization Active NPI

Modern Dental Professionals-Lee,Inc

Doing business as Monarch Dental

  • General Practice Dentistry
  • Springfield, OH
National Provider Identifier
1386828812
Registry record updated Dec 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30.019758 Issued in OH
Legal business name
MODERN DENTAL PROFESSIONALS-LEE,INC
Doing business as
Monarch Dental
Practice address
1475 Upper Valley Pike
Springfield, OH 45504-4047
Phone
(937) 322-7549
NPI assigned
Dec 19, 2007
Last updated
Dec 19, 2007By the provider in NPPES
Organization subpart
Yes
Parent organization
MODERN DENTAL PROFESSIONALS-LEE,INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 19, 2007

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

Authorized official

Name
Rhonda Keller
Title
District Manager
Phone
(937) 278-7956

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30.019758 OH Primary

Addresses

Primary practice location

1475 Upper Valley Pike
Springfield, OH 45504-4047

Mailing address

1475 Upper Valley Pike
Springfield, OH 45504-4047
Phone (937) 322-7549

Other identifiers 1

IdentifierTypeStateIssuer
2181419MedicaidOH

Other names 1

  • MONARCH DENTAL Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Modern Dental Professionals - Sandhu Inc9 organizations share this tax ID, including this one
Part of
Modern Dental Professionals - Sandhu Inc

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1198022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198022400000",
    "number": "1386828812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1475 UPPER VALLEY PIKE",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455044047",
            "telephone_number": "937-322-7549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 UPPER VALLEY PIKE",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455044047",
            "telephone_number": "937-322-7549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN DENTAL PROFESSIONALS-LEE,INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MODERN DENTAL PROFESSIONALS-LEE,INC",
        "enumeration_date": "2007-12-19",
        "last_updated": "2007-12-19",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_title_or_position": "DISTRICT MANAGER",
        "authorized_official_telephone_number": "937-278-7956"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.019758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2181419",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MONARCH DENTAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Springfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2007; 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.