BRIGHTNOW MESA COUNTRY CLUB DR
NPI 1063789816
Dentist - General Practice in Mesa, AZ

Active since November 22, 2011
1855 S COUNTRY CLUB DR, STE 101, MESA, AZ 85210(714) 428-2000 Get Directions Write a Review

NPPES record last updated: November 22, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Brightnow Mesa Country Club Dr NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRIGHTNOW MESA COUNTRY CLUB DR (NPI 1063789816) is a healthcare organization registered as a general practice in Mesa, Arizona and active in the NPI registry since November 2011. The organization lists Roy Smith, President, as its authorized official.

NPPES Registry Identity

NPI1063789816
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameMODERN DENTAL PROFESSIONALS - ARIZONA PC
Location Address1855 S COUNTRY CLUB DR, STE 101Mesa, AZ 85210-6037
Mailing Address1855 S Country Club Dr, Ste 101Mesa, AZ 85210-6037 · (714) 428-2000
Organization SubpartNo
Authorized OfficialRoy SmithPresident · (714) 428-2000
Enumeration DateNovember 22, 2011
NPI 1063789816 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

1855 S COUNTRY CLUB DR, Mesa, AZ 85210

Other Names 1

Doing Business AsBrightnow Mesa Country Club Dr

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Clinic/Center (Dental)
1855 S COUNTRY CLUB DR
MESA, AZ 85210
Dentist (General Practice)
1855 S COUNTRY CLUB DR, SUITE 101
MESA, AZ 85210

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Modern Dental Professionals - Arizona PC's NPI number?

The NPI number for Modern Dental Professionals - Arizona PC is 1063789816. It was assigned to this organization in the NPPES registry on November 22, 2011. The provider is doing business as Brightnow Mesa Country Club Dr.

Where is Modern Dental Professionals - Arizona PC located?

Modern Dental Professionals - Arizona PC is located at 1855 S Country Club Dr Ste 101, Mesa, AZ 85210. The listed phone number is (714) 428-2000.

What is Modern Dental Professionals - Arizona PC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Modern Dental Professionals - Arizona PC was last updated on November 22, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.