FOUNTAIN MODERN DENTISTRY AND ORTHODONTICS
NPI 1730434622
Dentist - General Practice in Irvine, CA

Q: What is Fountain Modern Dentistry And Orthodontics, LLP's specialty?

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

Active since July 17, 2012CLIA 06D2144174 · Waiver

2860 MICHELLE DRIVE 2ND FLOOR, IRVINE, CA 92606(714) 368-2077(714) 368-2092 Get Directions Write a Review

NPPES record last updated: July 17, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Fountain Modern Dentistry And Orthodontics NPPES

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

FOUNTAIN MODERN DENTISTRY AND ORTHODONTICS (NPI 1730434622) is a healthcare organization registered as a general practice in Irvine, California and active in the NPI registry since July 2012. The organization holds a CLIA Waiver certificate valid through February 11, 2028 and lists Charles Rodgers, Dds/ Owner, as its authorized official.

NPPES Registry Identity

NPI1730434622

Entity TypeOrganization

Primary Taxonomy1223G0001X

Legal Business NameFOUNTAIN MODERN DENTISTRY AND ORTHODONTICS, LLP

Location Address2860 MICHELLE DRIVE 2ND FLOORIrvine, CA 92606

Mailing Address6940 Mesa Ridge ParkwayFountain, CO 80817 · (719) 382-4936 · Fax (719) 382-4938

Phone(714) 368-2077

Fax(714) 368-2092

Organization SubpartNo

Authorized OfficialCharles RodgersDds/ Owner · (719) 382-4936

Enumeration DateJuly 17, 2012

✔ NPI 1730434622 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in CO · 9356

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.

2860 MICHELLE DRIVE 2ND FLOOR, Irvine, CA 92606

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Other Names 1

Doing Business AsFountain Modern Dentistry And Orthodontics

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

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 06D2144174

Fountain Modern Dentistry And Orthodontics · Fountain, CO

Active · expires Feb 11, 2028

CLIA Number06D2144174

Laboratory TypePhysician Office

Certificate Effective DateFebruary 12, 2026

Certificate Expiration DateFebruary 11, 2028

Laboratory DirectorDr. Scott Caims

Laboratory Phone(719) 382-4936

Laboratory LocationFountain Modern Dentistry And Orthodontics6940 Mesa Ridge Parkway, Fountain, CO 80817

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 Fountain Modern Dentistry And Orthodontics, LLP's NPI number?

The NPI number for Fountain Modern Dentistry And Orthodontics, LLP is 1730434622. It was assigned to this organization in the NPPES registry on July 17, 2012. The provider is doing business as Fountain Modern Dentistry And Orthodontics.

Where is Fountain Modern Dentistry And Orthodontics, LLP located?

Fountain Modern Dentistry And Orthodontics, LLP is located at 2860 Michelle Drive 2nd Floor, Irvine, CA 92606. The listed phone number is (714) 368-2077.

What is Fountain Modern Dentistry And Orthodontics, LLP's specialty?

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

Does Fountain Modern Dentistry And Orthodontics, LLP hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 06D2144174) is associated with this NPI, valid through February 11, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Fountain Modern Dentistry And Orthodontics, LLP was last updated on July 17, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.