MESA VALLEY MODERN DENTISTRY
NPI 1487190880
Dentist in Mesa, AZ

Q: What is Mesa Valley Modern Dentistry, LLP's NPI number?

The NPI number for Mesa Valley Modern Dentistry, LLP is 1487190880. It was assigned to this organization in the NPPES registry on January 10, 2017. The provider is doing business as Mesa Valley Modern Dentistry.

Q: What is Mesa Valley Modern Dentistry, LLP's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Active since January 10, 2017CLIA 03D2257086 · Waiver

1712 S, COUNTRY CLUB DRIVE, STE 104, MESA, AZ 85210(480) 376-0593 Get Directions Write a Review

NPPES record last updated: April 13, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 13, 2022, Aug 17, 2021, Jan 10, 2017 (3 updates tracked since 2017).

On this page

About Mesa Valley Modern Dentistry NPPES

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

MESA VALLEY MODERN DENTISTRY (NPI 1487190880) is a healthcare organization registered as a dentist in Mesa, Arizona and active in the NPI registry since January 2017. The organization holds a CLIA Waiver certificate valid through March 30, 2028 and lists Miran Ho, Owner, as its authorized official.

NPPES Registry Identity

NPI1487190880

Entity TypeOrganization

Primary Taxonomy122300000X

Legal Business NameMESA VALLEY MODERN DENTISTRY, LLP

Location Address1712 S, COUNTRY CLUB DRIVE, STE 104Mesa, AZ 85210

Mailing AddressPo Box 920050Dallas, TX 75392-0050 · (714) 845-8500 · Fax (949) 474-1495

Phone(480) 376-0593

Organization SubpartNo

Authorized OfficialMiran HoOwner · (480) 376-0593

Enumeration DateJanuary 10, 2017

Last NPPES UpdateApril 13, 20223 updates tracked since enumeration

NPPES CertifiedApril 13, 2022

✔ NPI 1487190880 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

1712 S, COUNTRY CLUB DRIVE, STE 104, Mesa, AZ 85210

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Other Names 1

Doing Business AsMesa Valley Modern Dentistry

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 03D2257086

Mesa Valley Modern Dentistry · Mesa, AZ

Active · expires Mar 30, 2028

CLIA Number03D2257086

Laboratory TypePractitioner Other

Certificate Effective DateMarch 31, 2026

Certificate Expiration DateMarch 30, 2028

Laboratory DirectorRichard Huynh

Laboratory Phone(480) 376-0593

Laboratory LocationMesa Valley Modern Dentistry1712 S Country Club Dr Ste 104, Mesa, AZ 85210

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

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 Mesa Valley Modern Dentistry, LLP's NPI number?

The NPI number for Mesa Valley Modern Dentistry, LLP is 1487190880. It was assigned to this organization in the NPPES registry on January 10, 2017. The provider is doing business as Mesa Valley Modern Dentistry.

Where is Mesa Valley Modern Dentistry, LLP located?

Mesa Valley Modern Dentistry, LLP is located at 1712 S, Country Club Drive, Ste 104, Mesa, AZ 85210. The listed phone number is (480) 376-0593.

What is Mesa Valley Modern Dentistry, LLP's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Does Mesa Valley Modern Dentistry, LLP hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 03D2257086) is associated with this NPI, valid through March 30, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Mesa Valley Modern Dentistry, LLP accept?

Health plans from Ambetter from Arizona Complete Health list Mesa Valley Modern Dentistry, LLP as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mesa Valley Modern Dentistry, LLP was last updated on April 13, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.