DR. AMY JO MODRALL (NPI# 1740250539) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740250539 |
| Entity Type | Individual |
| Full Name | DR. AMY JO MODRALL |
| Credential | D.D.S. |
| Practice Address |
2310 Fm Road 157 Suite 102 Mansfield TX 76063 |
| Practice Telephone | 8174772558 |
| Practice Fax Number | 8174739900 |
| Mailing Telephone | 8174772558 |
| Mailing Fax Number | 8174739900 |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
21998 | TX | Dental Providers |
| Street Address |
2310 FM ROAD 157 SUITE 102 |
| City | MANSFIELD |
| State | TX |
| Zip Code | 76063 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316558349 | Lindsey Vandyke, D.o. Pllc | Internal Medicine | 3150 E Broad Street, Ste 100, Mansfield, TX 76063 | 2020-08-13 |
| 1942819867 | Jennifer Que Chau Nguyen | Pharmacist | 980 U.S. 287 Frontage Rd #287, Mansfield, TX 76063 | 2020-07-27 |
| 1194346890 | Ana Maria Gonzalez | Dentist | 1600 Us Highway 287, Suite 102, Mansfield, TX 76063 | 2020-05-04 |
| 1245869080 | Stateserv Medical of Texas, LLC | Durable Medical Equipment & Medical Supplies | 7941 Rodeo Trail, Mansfield, TX 76063 | 2020-04-03 |
| 1649802232 | Mary Puanani Kamai | Nurse Practitioner | 1301 E. Debbie Lane, Suite 102 #1405, Mansfield, TX 76063 | 2020-02-11 |
| 1770123028 | Gladys Vera Nfodzo | Nurse Practitioner | 901 W. Broad St, Mansfield, TX 76063 | 2020-01-14 |
| 1669011300 | Alexa Smith | Nurse Practitioner | 2800 E Broad St #304, Mansfield, TX 76063 | 2019-12-28 |
| 1477190437 | Mel Rockwall LLC | Optometrist | 1701 East Broad Street, Ste 109, Mansfield, TX 76063 | 2019-12-09 |
| 1376185512 | Daniel Max & Marcandrea LLC | Optometrist | 1701 East Broad St., Ste 109, Mansfield, TX 76063 | 2019-10-09 |
| 1861046385 | Lacey Eaton | Counselor | 805 Killian Dr, Mansfield, TX 76063 | 2019-08-01 |
| Find all providers in zip 76063 | ||||
| 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 |
|---|---|---|---|---|
| 1578125688 | Abel David Lopez-portillo | Dentist | 3550 E Broad St, Mansfield, TX 76063-5633 | 2019-06-28 |
| 1073070066 | Today Dental of Mansfield North Pllc | Dentist | 1200 Highway 287 N Ste 101, Mansfield, TX 76063-2874 | 2019-02-26 |
| 1578090452 | Erin Hersey | Dentist | 292 Chauncy St # 150, Mansfield, MA 02048-1203 | 2017-05-22 |
| 1245688829 | Faith Amber Rheiner | Dentist | 1811 Highway 287 N Ste 160, Mansfield, TX 76063-7571 | 2016-05-24 |
| 1952652901 | Sarah Elizabeth Hopps | Dentist | 1510 Piedmont Dr, Mansfield, TX 76063-6046 | 2012-09-29 |
| 1659626505 | Michael Joseph Castle | Dentist | 2771 E Broad St Ste 221, Mansfield, TX 76063-9157 | 2012-07-17 |
| 1134485857 | Steven A. Sousa | Dentist | 26 Windchime Dr, Mansfield, MA 02048-2934 | 2012-04-06 |
| 1811268659 | Debbie Lane Dental & Orthodontics, Pllc | Dentist | 1551 Highway 287 N, Suite 411, Mansfield, TX 76063-8890 | 2012-01-25 |
| 1578846218 | Mansfield Smiles and Orthodontics, PC | Dentist | 3300 E Broad St Ste 120, Mansfield, TX 76063-5626 | 2011-09-20 |
| 1982992723 | Levy T Do | Dentist | 1560 E Debbie Ln Ste 108, Mansfield, TX 76063-8575 | 2011-07-14 |
| Find all providers in MANSFIELD | ||||
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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.