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General NPI Number Information
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NPI Number | 1639094527
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Entity Type | Individual
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Provider Name | ISHANI A MODI
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Gender | Female
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Dates
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Enumeration Date | 08/11/2026
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Last Update Date | 08/11/2026
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Provider Practice Location Address
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Address Line | 2114 SPRING VALLEY RD
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City | LANCASTER
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State | PA
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Zip | 17601-2427
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Country | US
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Telephone | 717-481-7645
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Fax |
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Provider Business Mailing Address
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Address Line | 204 BUTLER AVE STE 102
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City | LANCASTER
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State | PA
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Zip | 17601-6307
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Country | US
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Telephone | 717-481-8645
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DS046058
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License Number State | PA
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