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DELAWARE MODERN DENTAL NPI 1265585046


NPI Information

NPI: 1265585046
Provider Name: DELAWARE MODERN DENTAL
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
850 LIBRARY AVE
SUITE 102
NEWARK, DE
ZIP 19711
Phone: (302) 366-8668
Get Directions

DELAWARE MODERN DENTAL is a general practice dentist in Newark, DE. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. DELAWARE MODERN DENTAL NPI is 1265585046. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

850 LIBRARY AVE
SUITE 102
NEWARK, DE
ZIP 19711-170
Phone: (302) 366-8668
Fax: (302) 366-8081

The provider's authorized official is Lisa Fagioletti .
The authorized official title is Dentist and has the following contact phone number (302) 366-8668.

The enumeration date for this NPI number is 1/18/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral Practice2005207645DELAWAREYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11000028544MEDICAIDDELAWARE
21000036904MEDICAIDDELAWARE
31000037168MEDICAIDDELAWARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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