NPIMap

Organization Active NPI

Mugleston Green Valley Modern Dentistry, PC

Doing business as Green Valley Modern Dentistry

  • General Practice Dentistry
  • Henderson, NV
National Provider Identifier
1740650118
Registry record updated Sep 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MUGLESTON GREEN VALLEY MODERN DENTISTRY, PC
Doing business as
Green Valley Modern Dentistry
Practice address
4301 E Sunset Rd
100
Henderson, NV 89014-2238
Phone
(702) 465-8187
Fax
(702) 558-9278
NPI assigned
Sep 29, 2015
Last updated
Sep 29, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2015

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

Authorized official

Name
Dr. Cody P Mugleston, DMD
Title
Owner Dentist
Phone
(702) 465-8187

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

4301 E Sunset Rd
100
Henderson, NV 89014-2238

Mailing address

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

Other names 1

  • Green Valley Modern Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

4301 E Sunset Rd
#100
Henderson, NV 89014
Phone (702) 465-8187

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1443484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443484800000",
    "number": "1740650118",
    "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": "4301 E SUNSET RD",
            "address_2": "100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890142238",
            "telephone_number": "702-465-8187",
            "fax_number": "702-558-9278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUGLESTON GREEN VALLEY MODERN DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-29",
        "last_updated": "2015-09-29",
        "status": "A",
        "authorized_official_last_name": "MUGLESTON",
        "authorized_official_first_name": "CODY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "702-465-8187",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Green Valley Modern Dentistry",
            "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 Sep 29, 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.