# LAVEEN MODERN DENTISTRY, LLP

> 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:** Laveen Modern Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497064851
- **Authorized official:** DR. BRIAN NELSON DMD (OWNER DMD)
- **Authorized official phone:** (602) 237-0613

## Contact information

- **Practice address:** 5045 W BASELINE RD STE 135, LAVEEN, AZ 85339-7394
- **Practice address phone:** (602) 237-0613
- **Practice address fax:** (602) 237-0365
- **Mailing address:** 17000 RED HILL AVE, IRVINE, CA 92614-5626
- **Mailing address phone:** (714) 845-8890
- **Mailing address fax:** (949) 474-1495

## Taxonomy

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

## Other

- **Enumeration date:** 10/04/2010
- **Last updated:** 12/31/2013