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General NPI Number Information
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NPI Number | 1720391550
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Entity Type | Individual
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Provider Name | BHUMIKA MODI DDS
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Gender | Female
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Dates
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Enumeration Date | 07/21/2010
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Last Update Date | 11/15/2019
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Provider Practice Location Address
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Address Line | 25114 GROGANS MILL RD
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City | SPRING
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State | TX
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Zip | 77380-2360
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Country | US
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Telephone | 281-296-7600
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Fax |
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Provider Business Mailing Address
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Address Line | 132 FM 1960 RD STE B
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City | HOUSTON
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State | TX
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Zip | 77073-1814
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Country | US
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Telephone | 281-443-7777
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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 | 27419
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DS038366
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License Number State | PA
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