Individual provider Active NPI

Dominic Maglalang

  • Clinical Social Worker
  • Las Vegas, NV
National Provider Identifier
1053713594
Registry record updated Mar 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
13005-C Issued in NV
Practice address
1607 E Windmill LN Ste 300
Las Vegas, NV 89123-1910
Phone
(702) 757-8720
NPI assigned
Sep 16, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 13005-C NV Primary
Rehabilitation Practitioner 225400000X

Addresses

Primary practice location

1607 E Windmill LN Ste 300
Las Vegas, NV 89123-1910

Mailing address

1607 E Windmill LN Ste 300
Las Vegas, NV 89123-1910
Phone (702) 757-8720

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260417002111 NV Practitioner - Clinical Social Worker 4183190077 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1607 E Windmill LN
Suite 300
Las Vegas, NV 89123-1910

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13005-CNVMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Theravada Mental Health LLC Clinical CurrentSince Mar 1, 2026 Accepting new patients
Shining Star Community Services Rehabilitation Practitioner Past Accepting new patients
Shining Star Community Services Past Accepting new patients

Locations

2445 Fire Mesa St
Ste 270
Las Vegas, NV 89128
Phone (702) 212-3008

1607 E Windmill Ln
Ste 300
Las Vegas, NV 89123
Phone (702) 757-8720

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1410825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773100800000",
    "number": "1053713594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 E WINDMILL LN STE 300",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891231910",
            "telephone_number": "702-757-8720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1607 E WINDMILL LN STE 300",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891231910",
            "telephone_number": "702-757-8720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGLALANG",
        "first_name": "DOMINIC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-16",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "13005-C",
            "primary": true
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.