Healthcare Provider Details

I. General information

NPI: 1780518589
Provider Name (Legal Business Name): MODERN DENTAL CONCEPTS, GURSHARANJIT SINGH, DMD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4817 MAHONING AVE NW
WARREN OH
44483-1430
US

IV. Provider business mailing address

4817 MAHONING AVE NW
WARREN OH
44483-1430
US

V. Phone/Fax

Practice location:
  • Phone: 330-847-0676
  • Fax:
Mailing address:
  • Phone: 330-847-0676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. GURSHARANJIT SINGH
Title or Position: OWNER
Credential: DMD
Phone: 330-847-0676