Provider Demographics
NPI:1720391550
Name:MODI, BHUMIKA (DDS)
Entity Type:Individual
Prefix:DR
First Name:BHUMIKA
Middle Name:
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 1:132 FM 1960 RD STE B
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77073-1814
Mailing Address - Country:US
Mailing Address - Phone:281-443-7777
Mailing Address - Fax:
Practice Address - Street 1:25114 GROGANS MILL RD
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77380-2360
Practice Address - Country:US
Practice Address - Phone:281-296-7600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-21
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX274191223G0001X
PADS0383661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice