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St. Charles Modern Dental, LLC

General Practice Dentistry in St Charles, IL · enumerated 2010 · authorized official Kianor Shahmohmmadi, Ceo - Nexus Dentistry.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1912220773

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Registry record

Entity type Organization (Type 2)
Legal business name St. Charles Modern Dental, LLC
Other name <Unavail>
Practice address 855 S Randall Rd, St Charles, IL, 60174
Phone (630) 587-2700
Fax (630) 405-1738
Enumeration date Mar 9, 2010
Last updated in NPPES Mar 9, 2010

Taxonomy & classification

1223G0001X General Practice Dentistry Dental Providers · License 019027170 (IL) Primary

Authorized official

Name Kianor Shahmohmmadi
Title Ceo - Nexus Dentistry
Phone (618) 917-5808

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2010-03-09. Verify at npiregistry.cms.hhs.gov.
Where is St. Charles Modern Dental, LLC located?
The practice location on file with NPPES is in St Charles, IL.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2010-03-09.