NPIMap

Organization Active NPI

Mugleston Henderson Modern Dentistry, PC

  • General Practice Dentistry
  • Henderson, NV
National Provider Identifier
1558620823
Registry record updated Jan 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4908 Issued in NV
Legal business name
MUGLESTON HENDERSON MODERN DENTISTRY, PC
Doing business as
Henderson Modern Dentistry and Orthodontics
Practice address
366 W Lake Mead Pkwy Ste 100
Henderson, NV 89015-7287
Phone
(702) 464-3090
Fax
(702) 464-3158
NPI assigned
May 8, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2014

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

Authorized official

Name
Dr. Cody P Mugleston
Title
DDS-Owner
Phone
(702) 464-3090

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 4908 NV Primary

Addresses

Primary practice location

366 W Lake Mead Pkwy Ste 100
Henderson, NV 89015-7287

Mailing address

17000 Red Hill Ave
Irvine, CA 92614-5626
Phone (714) 845-8890

Other names 1

  • Henderson Modern Dentistry and Orthodontics Doing business as

National Provider Directory

National Provider Directory
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.

NPI Registry JSON

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

{
    "created_epoch": "1336435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389744000000",
    "number": "1558620823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 RED HILL AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145626",
            "telephone_number": "714-845-8890",
            "fax_number": "949-474-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "366 W LAKE MEAD PKWY STE 100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890157287",
            "telephone_number": "702-464-3090",
            "fax_number": "702-464-3158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUGLESTON HENDERSON MODERN DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-08",
        "last_updated": "2014-01-15",
        "status": "A",
        "authorized_official_last_name": "MUGLESTON",
        "authorized_official_first_name": "CODY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "DDS-OWNER",
        "authorized_official_telephone_number": "702-464-3090",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "4908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Henderson Modern Dentistry and Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2014; 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.