TEJAS MODI DDS INC (NPI# 1134329030) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134329030 |
| Entity Type | Organization |
| Organization Name | TEJAS MODI DDS INC |
| Practice Address |
75 W Nuevo Rd Ste A&b Perris CA 92571 |
| Mailing Address |
75 W. Nuevo Rd, Suite A & B Perris CA 92571-0801 |
| Practice Telephone | 9516571203 |
| Mailing Telephone | 9516571203 |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2018-08-22 |
| Authorized Official Name | TEJAS MODI (PRESIDENT) |
| Authorized Official Telephone | 9516571203 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | D50823 | CA | Dental Providers |
| N | 122300000X | Dentist | D36129 | CA | Dental Providers |
| N | 122300000X | Dentist | D43182 | CA | Dental Providers |
| N | 122300000X | Dentist | D54136 | CA | Dental Providers |
| Y | 1223G0001X |
Dentist Specialization: General Practice |
D 47131 | CA | Dental Providers |
| Street Address |
75 W NUEVO RD STE A&B |
| City | PERRIS |
| State | CA |
| Zip Code | 92571 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376199422 | Pico De Loro, Incorporated | Assisted Living Facility | 620 North Perris Boulevard, Perris, CA 92571 | 2019-08-14 |
| 1053802579 | Kadiatou Dafney | Nurse Practitioner | 126 Avocado Ave Ste 106, Perris, CA 92571 | 2018-05-21 |
| 1730677014 | Ruth Gasselle Rodriguez | Nutritionist | 1020 Huntington Way, Perris, CA 92571 | 2018-04-23 |
| 1649788167 | Leslie Bautista | Counselor | 1276 Autumnwood Ln, Perris, CA 92571 | 2018-01-18 |
| 1588180459 | Eduardo Orozco-zavala | Licensed Vocational Nurse | 85 Ramona Expressway, Suite 1, Perris, CA 92571 | 2017-08-22 |
| 1396267365 | National Vision, Inc. | Technician/Technologist | 1850 N Perris Boulevard, Suite 40, Perris, CA 92571 | 2017-07-12 |
| 1336669506 | Gary Huang | Optometrist | 1850 N Perris Boulevard Ste 40, Perris, CA 92571 | 2017-06-20 |
| 1750814745 | New Beginnings Residential Tf | Residential Treatment Facility, Emotionally Disturbed Children | 106 Worth St, Perris, CA 92571 | 2017-04-06 |
| 1013456235 | Sohal and Pham Dental Corporation | Dentist | 1820 Perris Blvd, Suite 70, Perris, CA 92571 | 2017-02-21 |
| 1093267569 | New Beginnings Residential Tf | Residential Treatment Facility, Emotionally Disturbed Children | 2464 Slew of Gold Ct, Perris, CA 92571 | 2016-10-31 |
| Find all providers in zip 92571 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| 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. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407259427 | Carlos Enrique Cullampe Torrejon | Dentist | 2055 N Perris Blvd Ste E10-12, Perris, CA 92571-2509 | 2014-10-04 |
| 1477866366 | Justin William Mercer | Dentist | 3150 Case Rd Bldg C, Perris, CA 92570-5552 | 2010-07-20 |
| 1528249281 | Mercer and Pham Dental Corporation | Dentist | 3150 Case Road, Building C, Perris, CA 92570 | 2007-11-21 |
| 1710197876 | Alberto Sueldo | Dentist | 85 Ramona Expy, Ste #7, Perris, CA 92571-7014 | 2007-05-23 |
| 1760691174 | Cox Dental Corporation | Dentist | 2560 North Perris Blvd, Suite F-1, Perris, CA 92571-3226 | 2007-05-22 |
| 1699864348 | Andrea K Choi | Dentist | 1688 N Perris Blvd Ste G1, Perris, CA 92571-4744 | 2006-10-12 |
| 1669901286 | Jereme Dewayne Berryhill | Dentist | 3150 Case Rd Bldg C, Perris, CA 92570-5552 | 2017-06-07 |
| 1194252627 | Cheerag Amin | Dentist | 3150 Case Rd Bldg C, Perris, CA 92570-5552 | 2017-05-15 |
| 1932655685 | Trevor Jamal Thomas | Dentist | 3150 Case Rd, Building C, Perris, CA 92570 | 2016-08-31 |
| 1861834988 | Perris Dental | Dentist | 2055 N Perris Blvd, Ste E-12, Perris, CA 92571-2509 | 2013-07-18 |
| Find all providers in PERRIS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.