OrganizationActive
St. Charles Modern Dental, LLC
NPI 1912220773 · General Practice Dentistry · St Charles, IL
St. Charles Modern Dental, LLC is a General Practice Dentistry organization in St Charles, IL (NPI 1912220773).
Provider details
- NPI number
- 1912220773
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Kianor Shahmohmmadi, Ceo - Nexus Dentistry(618) 917-5808
- License
- 019027170 (IL)
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(84/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
16 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
855 S Randall Rd
St Charles, IL 60174-1570
Phone: (630) 587-2700
Fax: (630) 405-1738
Street-level locationGet directions
Mailing address
855 S Randall Rd
St Charles, IL 60174-1570
Other names (DBA / former)
- Other name
- St. Charles Modern Dental
Registry dates
- Enumerated
- 2010-03-09
- Last updated
- 2010-03-09
Frequently asked questions
- What is St. Charles Modern Dental, LLC's NPI number?
- St. Charles Modern Dental, LLC's National Provider Identifier (NPI) is 1912220773, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is St. Charles Modern Dental, LLC?
- St. Charles Modern Dental, LLC is classified in the NPPES registry as General Practice Dentistry (Dental Providers).
- Where is St. Charles Modern Dental, LLC located?
- St. Charles Modern Dental, LLC's practice location on file with NPPES is 855 S Randall Rd, St Charles, IL 60174-1570.
- What is St. Charles Modern Dental, LLC's phone number?
- The practice phone number listed in the NPPES registry for St. Charles Modern Dental, LLC is (630) 587-2700.
- Who is the authorized official for St. Charles Modern Dental, LLC?
- The authorized official listed on St. Charles Modern Dental, LLC's NPPES record is Kianor Shahmohmmadi, Ceo - Nexus Dentistry. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is St. Charles Modern Dental, LLC's NPI active?
- Yes — St. Charles Modern Dental, LLC's NPI (1912220773) is active in the NPPES registry as of the last update on 2010-03-09.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.