Henderson Modern Dentistry

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6650 Issued in NV

Legal business name

HENDERSON MODERN DENTISTRY

Practice address

386 W Lake Mead Pkwy
Suite 100
Henderson, NV 89015-7417

Phone

(702) 464-3090

NPI assigned

Jul 18, 2015

Last updated

Jul 18, 2015By 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. Cody Mugleston, D.M.D.

Title

Owner Doctor

Phone

(702) 464-3090

Specialties & licenses 1

Addresses

Tax ID family

Henderson Modern Dentistry2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Mugleston Henderson Modern Dentistry, PC

  dba Henderson Modern Dentistry and Orthodontics

  • General Practice Dentistry
  • Henderson, NV
  • NPI 1558620823
  NPD tax ID

Locations

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

{
    "created_epoch": "1437177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437177600000",
    "number": "1083098032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "831 CORONADO CENTER DR",
            "address_2": "#22205",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890523991",
            "telephone_number": "516-343-8731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "386 W LAKE MEAD PKWY",
            "address_2": "SUITE 100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890157417",
            "telephone_number": "702-464-3090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENDERSON MODERN DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-18",
        "last_updated": "2015-07-18",
        "status": "A",
        "authorized_official_last_name": "MUGLESTON",
        "authorized_official_first_name": "CODY",
        "authorized_official_title_or_position": "OWNER DOCTOR",
        "authorized_official_telephone_number": "702-464-3090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "6650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Henderson Hospital (ER at Cadence)
• Henderson Hospital (ER at Green Valley Ranch)
• Henderson Hospital
• Henderson Knee and Joint Clinic LLC
• Henderson Long Term Care LLC (Green Valley Health and Wellness Suites)
• Henderson OB/GYN LLC
• Henderson Operating Company LLC (Lake Mead Health & Rehabilitation Center)
• Henderson Pediatric Dentistry Hon DMD PC (Cosmic Kids Dental)
• Henderson Pediatric Dentistry PC
• Henderson Pediatrics PLLC

• General Practice Dentistry in Henderson, NV
• Providers in Henderson, NV by specialty
• General Practice Dentistry in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2015; 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.