Provider record
Port Orange Modern Dentistry, PA
The public CMS NPPES listing for Port Orange Modern Dentistry, PA places this Dentist record in Port Orange, FL. The practice address is shown as 1765 Dunlawton Ave., Port Orange, FL. NPPES also reports a phone number. Verify details before visiting or calling.
National Plan and Provider Enumeration System
Data pulled and checked
Reported to NPPES
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We show source-reported CMS NPPES fields.
Confirm details directly with the provider.NPI and status
Source-labeled identifiers and reported record state.
- NPI
- 1982179818
- Entity type
- Organization
- NPPES status
- Reported active
- License status
- Not primary-source verified
Practice location
Practice address and phone as reported in CMS NPPES.
- Address
- 1765 Dunlawton Ave., Suite 103
Port Orange, FL 32129 - Phone
- (386) 259-3905
Directions
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How to verify this record
Use this page as a starting point, then confirm details from primary or direct sources.
- Confirm the office address and phone number directly with the provider.
- Use the NPI number when comparing this record with CMS NPPES.
- Check state licensing sources separately for license status or disciplinary history.
- Ask the office about insurance, appointments, services, and availability.
Taxonomy and source
Specialty taxonomy is source-reported and not a quality or license determination.
- Taxonomy code
- 122300000X
- Specialty
- Dentist
- Source
- CMS NPPES
- Last updated
- May 26, 2026