Active NPI
Primesh Modi
- General Practice Dentistry
- Hixson, TN
National Provider Identifier
1447687009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DS0000009315
- Practice address
- 5550 Highway 153 Ste 100
Hixson, TN 37343-4991 - Phone
- (423) 822-8409
- NPI assigned
- Sep 27, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DS0000009315 | TN | Primary |
Addresses
Primary practice location
5550 Highway 153 Ste 100
Hixson, TN 37343-4991
Mailing address
5550 Highway 153 Ste 100
Hixson, TN 37343-4991
Phone (423) 822-8409
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS0000009315 | TN | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1415145600000",
"number": "1447687009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5550 HIGHWAY 153 STE 100",
"city": "HIXSON",
"state": "TN",
"postal_code": "373434991",
"telephone_number": "423-822-8409"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5550 HIGHWAY 153 STE 100",
"city": "HIXSON",
"state": "TN",
"postal_code": "373434991",
"telephone_number": "423-822-8409"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MODI",
"first_name": "PRIMESH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-09-27",
"last_updated": "2014-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TN",
"license": "DS0000009315",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hixson, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.