Modern Family Dental

Primary specialty

DentistTaxonomy code 122300000X

License

DS020595L Issued in PA

Legal business name

MODERN FAMILY DENTAL

Practice address

1131 S 19TH St
Philadelphia, PA 19146-2936

Phone

(215) 546-0388

NPI assigned

Nov 14, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Nigar Aftab, DDS

Title

Owner

Phone

(484) 686-3723

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1415923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415923200000",
    "number": "1922404185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1131 S 19TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191462936",
            "telephone_number": "215-546-0388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 S 19TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191462936",
            "telephone_number": "215-546-0388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-14",
        "last_updated": "2014-11-14",
        "status": "A",
        "authorized_official_last_name": "AFTAB",
        "authorized_official_first_name": "NIGAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "484-686-3723",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS020595L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005290510001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102595694001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Modacare Home Care Agency LLC
• Anurag Modak, MD
• Heather J Moday, M.D.
• Modern Dentistry and Cosmetology Center
• Modern Eye Inc
• Modern Health Home Care
• Modern Optometry, Inc.
• Modern Relationships LLC
• Modern Wellness Collective LLC
• Modernminds Wellness Care PLLC

• Dentist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.

Verify at the official NPI Registry.