MGM Dental PA

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

DN20484 Issued in FL

Legal business name

MGM DENTAL PA

Practice address

15659 SW 88TH St
Miami, FL 33196

Phone

(786) 558-7315

Fax

(786) 558-7318

NPI assigned

Mar 11, 2011

Organization subpart

No

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

Authorized official

Name

Maria Gabriela Mogollon, DDSNPI 1548403579

Title

Owner

Phone

(786) 597-1636

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Maria Gabriela Mogollon, D.D.S.

  • Dentist
  • Miami, FL
  • NPI 1548403579
  NPD (past) Authorized official

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

{
    "created_epoch": "1299801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530489600000",
    "number": "1396043576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15659 SW 88TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331961103",
            "telephone_number": "786-558-7315",
            "fax_number": "786-558-7318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15659 SW 88TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33196",
            "telephone_number": "786-558-7315",
            "fax_number": "786-558-7318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MGM DENTAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-11",
        "last_updated": "2018-07-02",
        "status": "A",
        "authorized_official_last_name": "MOGOLLON",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "GABRIELA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-597-1636",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "FL",
            "license": "DN20484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• MG Rehab Center of Miami Inc
• MG Rehabilitation Center Inc
• MG Therapeutic Rehabilitation Corp
• MG West Medical Supplies Corp
• MGL Therapy Services LLC
• MGM Medical Services Inc
• MGM Outpatient Inc
• MGM Pharmacy & Discount Corp
• MGM Therapy Services LLC
• MGR Garcia Services LLC

• Dental Clinic/Center in Miami, FL
• Providers in Miami, FL by specialty
• Dental Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2018; 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.