Active NPI
Mahogandy Dennis
- Licensed Vocational Nurse
- Rialto, CA
National Provider Identifier
1588174320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Vocational Nurse
- License
- VN221941
- Practice address
- 3471 N Woodruff CT
Rialto, CA 92377-3646 - Phone
- (909) 614-9531
- NPI assigned
- Oct 6, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Vocational Nurse | 164X00000X | VN221941 | CA | Primary |
Addresses
Primary practice location
3471 N Woodruff CT
Rialto, CA 92377-3646
Mailing address
20258 U.S Highway 18
Suite 430 #466
Apple Valley, CA 92307
Phone (760) 885-1609
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| VN221941 | CA | MD | Licensed Vocational Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507248000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1507248000000",
"number": "1588174320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20258 U.S HIGHWAY 18",
"address_2": "SUITE 430 #466",
"city": "APPLE VALLEY",
"state": "CA",
"postal_code": "92307",
"telephone_number": "760-885-1609"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3471 N WOODRUFF CT",
"city": "RIALTO",
"state": "CA",
"postal_code": "923773646",
"telephone_number": "909-614-9531"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DENNIS",
"first_name": "MAHOGANDY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-10-06",
"last_updated": "2017-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "164X00000X",
"taxonomy_group": "",
"desc": "Licensed Vocational Nurse",
"state": "CA",
"license": "VN221941",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rialto, CA
- Nenia De Leon-Figueroa, M.S
- Sherry Dearmore, R.N.
- Erica Decker, LCSW
- Kameron D Dees
- Almi Kristine Del Villar, F.N.P.
- Victor Eduardo Dennis, DPT
- Dental Care of Rialto Inc
- Department of Behavior Health
- Department of Behavioral Health, San Bernardino County Ca (Agewise)
- Department of Behaviour Health, SB County
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.