# MODERN SMILES PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Modern Smiles
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164292256
- **Authorized official:** CHAD HENDRICKS (CREDENTIALING)
- **Authorized official phone:** (612) 859-0444

## Contact information

- **Practice address:** 2933 W CACTUS RD, PHOENIX, AZ 85029-2346
- **Practice address phone:** (602) 863-9079
- **Mailing address:** 2933 W CACTUS RD, PHOENIX, AZ 85029-2346
- **Mailing address phone:** (602) 863-9079

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 01/08/2024
- **Last updated:** 01/08/2024