Provider Demographics
NPI:1760533111
Name:MODI, NEEPA BIPIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:NEEPA
Middle Name:BIPIN
Last Name:MODI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 S 12TH ST APT 350
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68102-2891
Mailing Address - Country:US
Mailing Address - Phone:312-399-9440
Mailing Address - Fax:312-526-3902
Practice Address - Street 1:515 S 12TH ST APT 350
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68102-2891
Practice Address - Country:US
Practice Address - Phone:312-399-9440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-14
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190262491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice