| Modern Dental LLC | |
|
5912 E 18 Street Sioux Falls SD 57110 | |
| (605) 261-4697 | |
| Not Available |
| Full Name | Modern Dental LLC |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5912 E 18 Street, Sioux Falls, South Dakota |
| Authorized Official Name and Position | Chris Diaz-freed (OWNER) |
| Authorized Official Contact | 6052614697 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Modern Dental LLC 8604 S Quiet Oak Cir Sioux Falls SD 57108-4138 Ph: (605) 261-4697 | Modern Dental LLC 5912 E 18 Street Sioux Falls SD 57110 Ph: (605) 261-4697 |
| NPI Number | 1265309496 |
|---|---|
| Provider Enumeration Date | 10/22/2025 |
| Last Update Date | 10/22/2025 |
| Certification Date | 10/02/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265309496 | NPI | - | NPPES |
| 1275784605 | Medicaid | SD | |
| 1710141726 | Medicaid | SD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (NU) | Primary |
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