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

Modern Oral & Facial Surgery

Organization Oral & Maxillofacial Surgery (D.M.D.) · NPI 1902479025

Modern Oral & Facial Surgery is an Oral & Maxillofacial Surgery (D.M.D.) in Rockville, Maryland. Registered with an NPI since 2021.

In the registry since
2021

Practice location Address checks out

6191 Executive Blvd
Rockville, MD 20852-3901
Phone: (301) 610-3918
Fax: (301) 610-3781
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral & Maxillofacial Surgery (D.M.D.) (primary) Taxonomy 204E00000X

Record details

NPI number1902479025
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Cyrus Mistry — Owner · (301) 610-3918
NPI enumeratedJuly 19, 2021
Last updated in NPPESJuly 20, 2021
Certification dateJuly 20, 2021
Mailing address6191 Executive Blvd, Rockville, MD 20852-3901

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