Modi and Shah D.D.S. Inc.,

Primary specialty

DentistTaxonomy code 122300000X

License

D47131 Issued in CA

Legal business name

MODI AND SHAH D.D.S. INC.,

Practice address

28039 Scott Rd Ste I
Murrieta, CA 92563-7430

Phone

(951) 246-8000

Fax

(951) 246-8002

NPI assigned

Jul 17, 2007

Organization subpart

No

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

Authorized official

Name

Tejas Modi

Title

President

Phone

(951) 246-8000

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184630400000",
    "number": "1932308079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28039 SCOTT RD STE I",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925637430",
            "telephone_number": "951-246-8000",
            "fax_number": "951-246-8002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28039 SCOTT RD STE I",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925637430",
            "telephone_number": "951-246-8000",
            "fax_number": "951-246-8002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODI AND SHAH D.D.S. INC.,",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-17",
        "last_updated": "2007-07-17",
        "status": "A",
        "authorized_official_last_name": "MODI",
        "authorized_official_first_name": "TEJAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-246-8000"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "D47131",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "D50823",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "D43182",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2007; 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.