Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Port Orange Modern Dentistry, PA

Organization Dentist · NPI 1982179818

Port Orange Modern Dentistry, PA provides Dentist services in Port Orange, Florida. Registered with an NPI since 2018.

In the registry since
2018
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

1765 Dunlawton Ave Ste 103
Port Orange, FL 32129
Phone: (386) 259-3905
Fax: (386) 259-3905
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X

Record details

NPI number1982179818
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Minh Pham — Owner/Gp · (386) 259-3905
Other names Port Orange Modern Dentistry; Port Orange Modern Dentistry
NPI enumeratedOctober 8, 2018
Last updated in NPPESAugust 25, 2022
Certification dateAugust 25, 2022
Mailing addressPo Box 920050, Dallas, TX 75392-0050

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