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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

MODERN DENTAL CENTER LLC
NPI 1689320897
Dentist in Fond Du Lac, WI

Active since February 25, 2022
101 CAMELOT DR STE 3, FOND DU LAC, WI 54935(920) 921-1244 Get Directions Write a Review

NPPES record last updated: July 21, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 21, 2026, Feb 25, 2022 (2 updates tracked since 2022).

About Modern Dental Center Llc NPPES

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

MODERN DENTAL CENTER LLC (NPI 1689320897) is a healthcare organization registered as a dentist in Fond Du Lac, Wisconsin and active in the NPI registry since February 2022. The organization lists Victoria Johnson, Cro, as its authorized official.

NPPES Registry Identity

NPI1689320897
Entity TypeOrganization
Primary Taxonomy122300000X
Legal Business NameMODERN DENTAL CENTER LLC
Location Address101 CAMELOT DR STE 3Fond Du Lac, WI 54935-8048
Mailing Address101 Camelot Dr Ste 3Fond Du Lac, WI 54935-8048 · (920) 921-1244
Phone(920) 921-1244
Organization SubpartNo
Authorized OfficialVictoria JohnsonCro · (941) 444-0558
Enumeration DateFebruary 25, 2022
Last NPPES UpdateJuly 21, 20262 updates tracked since enumeration
NPPES CertifiedJuly 21, 2026
✔ NPI 1689320897 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.
101 CAMELOT DR STE 3, Fond Du Lac, WI 54935
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Other Names 1

Other NameDental Care Alliance

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

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

JOSEPH T ANDRINGA
Dentist (General Practice)
101 CAMELOT DR STE 3
FOND DU LAC, WI 54935
Fond Du Lac County (708) 752-0246
WILLIAM C MAUTHE III DDS
Dentist (General Practice)
101 CAMELOT DR STE 3
FOND DU LAC, WI 54935
Fond Du Lac County (920) 921-1244
WILLIAM C MAUTHE DDS
Dentist (General Practice)
101 CAMELOT DR STE 3
FOND DU LAC, WI 54935
Fond Du Lac County (920) 921-1244

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 Center LLC's NPI number?

The NPI number for Modern Dental Center LLC is 1689320897. It was assigned to this organization in the NPPES registry on February 25, 2022. The provider is also known as Dental Care Alliance.

Where is Modern Dental Center LLC located?

Modern Dental Center LLC is located at 101 Camelot Dr Ste 3, Fond Du Lac, WI 54935. The listed phone number is (920) 921-1244.

What is Modern Dental Center LLC's specialty?

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

When was this NPI record last updated?

The NPPES record for Modern Dental Center LLC was last updated on July 21, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.