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

Shady Grove Modern Dental PC

Organization Dentist · NPI 1508802414

Shady Grove Modern Dental PC is a Dentist in Gaithersburg, Maryland. Licensed in Maryland. Registered with an NPI since 2006.

Licensed in
MD
In the registry since
2006
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

9051 Shady Grove Ct
Gaithersburg, MD 20877
Phone: (301) 330-4613
Fax: (301) 330-4619
Show map & directions

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

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 11662 (MD)

Record details

NPI number1508802414
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Duy Tam Tran Kiem — President · (301) 330-4613
NPI enumeratedJune 20, 2006
Last updated in NPPESAugust 22, 2020
Mailing address9051 Shady Grove Court, Gaithersburg, MD 20877

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