NPIMap

Organization Active NPI

Modarres Dental Group

  • Dentist
  • Ellicott City, MD
National Provider Identifier
1891274759
Registry record updated Aug 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
MODARRES DENTAL GROUP
Practice address
10132 Baltimore National Pike Ste C
Ellicott City, MD 21042-3607
Phone
(410) 465-3224
NPI assigned
Aug 11, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2018

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

Authorized official

Name
Dr. Alireza Modarres, DDS, MSNPI 1548427636
Title
Ceo
Phone
(443) 928-9697

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

10132 Baltimore National Pike Ste C
Ellicott City, MD 21042-3607

Mailing address

7000 Braeburn PL
Bethesda, MD 20817-4908
Phone (443) 928-9697

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1533945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533945600000",
    "number": "1891274759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7000 BRAEBURN PL",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208174908",
            "telephone_number": "443-928-9697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10132 BALTIMORE NATIONAL PIKE STE C",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210423607",
            "telephone_number": "410-465-3224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODARRES DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-11",
        "last_updated": "2018-08-11",
        "status": "A",
        "authorized_official_last_name": "MODARRES",
        "authorized_official_first_name": "ALIREZA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "443-928-9697",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2018; 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.