Lumina LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

LUMINA LLC

Doing business as

Mangilao Dental Clinic

Practice address

353 Route 10 Ste 101
Mangilao, GU 96913-1392

Phone

(671) 969-4242

NPI assigned

Nov 12, 2020

Last updated

Nov 13, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Sarah Lee Clegg, DDSNPI 1457764417

Title

Owner

Phone

(510) 283-3460

Specialties & licenses 1

Addresses

Other names 1

• Mangilao Dental Clinic Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sarah Lee Clegg, D.D.S

  • General Practice Dentistry
  • Tamuning, GU
  • NPI 1457764417
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1605139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605225600000",
    "number": "1003418369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9868",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969315868",
            "telephone_number": "510-283-3460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 ROUTE 10 STE 101",
            "city": "MANGILAO",
            "state": "GU",
            "postal_code": "969131392",
            "telephone_number": "671-969-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUMINA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-12",
        "last_updated": "2020-11-13",
        "certification_date": "2020-11-13",
        "status": "A",
        "authorized_official_last_name": "CLEGG",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "510-283-3460",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mangilao Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Government of Guam Department of Administration (Guam Department of Public Health Central Region Community Health Cente)
• Stephen Paul Guilliot
• Joon Ha, DDS
• Honey Rizza Ang Imbo, LCSW
• Antoinette Marie Kleiner, FNP
• Janna Wilgus Manglona, M.D.
• Jolan Su McNinch, RD,LD
• Newgen Aesthetics & Wellness, LLC (NewGen Physical Therapy)
• Newgen Peak Performance, LLC (NewGen Peak Performance)
• Elizabeth Rabon

• Dental Clinic/Center in Mangilao, GU
• Providers in Mangilao, GU by specialty
• Dental Clinic/Center in Guam

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.