Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lake Jackson Modern Dentistry, PC

Organization Dentist · NPI 1821472507

Lake Jackson Modern Dentistry, PC is a Dentist in Irvine, California. Registered with an NPI since 2015.

In the registry since
2015
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

17000 Red Hill Ave
Irvine, CA 92614-5626
Phone: (714) 845-8890
Fax: (949) 474-1495
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X

Record details

NPI number1821472507
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official John Barnes — Owner Doctor · (979) 583-6005
Other names Lake Jackson Modern Dentistry
NPI enumeratedJuly 13, 2015
Last updated in NPPESJuly 13, 2015
Mailing address97 Oyster Creek Dr Suite 130, Lake Jackson, TX 77566

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