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Contact Information

MODERN DENTAL LLC
5912 E 18 STREET
SIOUX FALLS, SD57110
 Phone: 605-261-4697
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for MODERN DENTAL LLC · (Female)

NPI Number 1265309496
Status Active
Credentials
Entity Individual
Enumeration date 10/22/2025
Last updated 10/22/2025 - About 8 months ago
Sole proprietor 1 Not specified
Identifiers
  • SD Medicaid 1275784605
  • SD Medicaid 1710141726
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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