Marmar Modarressi, DDS, MS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

019.028205 Issued in IL

Practice address

845 N Michigan Ave Ste 940W
Chicago, IL 60611-2216

Phone

(312) 751-1020

NPI assigned

Jul 10, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Periodontal Associates, LLP

  • Periodontics
  • Chicago, IL
  • NPI 1508355678
  NPD (past)
• Perfect Teeth - South 8TH Street P.C.

  • General Practice Dentistry
  • Colorado Springs, CO
  • NPI 1811018211
  NPD (past)

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1699973636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 N MICHIGAN AVE STE 940W",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112216",
            "telephone_number": "312-751-1020",
            "fax_number": "312-751-1231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 N MICHIGAN AVE STE 940W",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112216",
            "telephone_number": "312-751-1020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODARRESSI",
        "first_name": "MARMAR",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-10",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "IL",
            "license": "019.028205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Mock, OTD
• Jane Mockaitis, RD
• Aeleah Lane Mockler, DNP, CRNA
• Nancy Moctezuma-Lopez
• Modarai, D.O., S.C.
• Modern Chicago Therapy
• Modern Compassionate Care
• Modern Compassionate Counseling
• Modern Dental of Logan Square LLC
• Modern Dental on Clark Street

• Periodontics in Chicago, IL
• Providers in Chicago, IL by specialty
• Periodontics in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; 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.