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

St Charles Modern Dental, LLC

Organization General Practice Dentistry · NPI 1912220773

St Charles Modern Dental, LLC is a General Practice Dentistry in St Charles, Illinois. Licensed in Illinois. Registered with an NPI since 2010.

Licensed in
IL
In the registry since
2010
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

855 S Randall Rd
St Charles, IL 60174-1570
Phone: (630) 587-2700
Fax: (630) 405-1738
Show map & directions

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

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 019027170 (IL)

Record details

NPI number1912220773
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kianor Shahmohmmadi — Ceo - Nexus Dentistry · (618) 917-5808
Other names St. Charles Modern Dental
NPI enumeratedMarch 9, 2010
Last updated in NPPESMarch 9, 2010
Mailing address855 S Randall Rd, St Charles, IL 60174-1570

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