Active NPI
Nicole Mouganis, DMD
- Dentist
- Camp Pendleton, CA
National Provider Identifier
1861285520
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 14282800-9926
- Practice address
- 200 Mercy CT
Camp Pendleton, CA 92055 - Phone
- (703) 618-2000
- NPI assigned
- May 27, 2025
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 14282800-9926 | UT | Primary |
Addresses
Primary practice location
200 Mercy CT
Camp Pendleton, CA 92055
Mailing address
187 Newton M Johnson Dr
Bumpass, VA 23024-4346
Phone (703) 618-2000
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 |
|---|---|---|---|
| 0401419437 | VA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1748304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784073600000",
"number": "1861285520",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "187 NEWTON M JOHNSON DR",
"city": "BUMPASS",
"state": "VA",
"postal_code": "230244346",
"telephone_number": "703-618-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 MERCY CT",
"city": "CAMP PENDLETON",
"state": "CA",
"postal_code": "92055",
"telephone_number": "703-618-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOUGANIS",
"first_name": "NICOLE",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-05-27",
"last_updated": "2026-07-15",
"certification_date": "2026-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "UT",
"license": "14282800-9926",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Camp Pendleton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.