Active NPI
Nisha Modi, DMD
- Dentist
- Aubrey, TX
National Provider Identifier
1689074346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 30422
- Practice address
- 1001 S Highway 377
107
Aubrey, TX 76227 - Phone
- (469) 346-6612
- NPI assigned
- Sep 1, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 30422 | TX | Primary |
Addresses
Primary practice location
1001 S Highway 377
107
Aubrey, TX 76227
Mailing address
8628 Forest Glen Dr
Irving, TX 75063-4201
Phone (214) 864-6515
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 |
|---|---|---|---|
| 30422 | TX | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Miracle Smile Family Dental and Orthodontics PLLC | Current | Accepting new patients |
Locations
1001 S Highway 377
#107
Aubrey, TX 76227
Phone (469) 346-6112
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Aubrey, TX
- NPI 1174278311
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1409529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654732800000",
"number": "1689074346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8628 FOREST GLEN DR",
"city": "IRVING",
"state": "TX",
"postal_code": "750634201",
"telephone_number": "214-864-6515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 S HIGHWAY 377",
"address_2": "107",
"city": "AUBREY",
"state": "TX",
"postal_code": "76227",
"telephone_number": "469-346-6612"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MODI",
"first_name": "NISHA",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-09-01",
"last_updated": "2022-06-09",
"certification_date": "2022-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "30422",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aubrey, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.