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

Wildwood Modern Dentistry, PA

Organization General Practice Dentistry · NPI 1063222149

Wildwood Modern Dentistry, PA is a General Practice Dentistry in Wildwood, Florida. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5297 Sundance Trl
Wildwood, FL 34785-7717
Phone: (352) 663-9773
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X

Record details

NPI number1063222149
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jerin Joseph — Owner · (714) 845-8500
NPI enumeratedJanuary 10, 2025
Last updated in NPPESJanuary 10, 2025
Certification dateJanuary 10, 2025
Mailing addressPo Box 660041, Dallas, TX 75266-0041

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