Long Mugianto, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

27450 Issued in TX

Practice address

3400 Lombardy LN Ste 100
Dallas, TX 75220-3315

Phone

(214) 350-5333

Fax

(214) 350-8555

NPI assigned

May 24, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pecan Plaza Dental, P.a.

  • General Practice Dentistry
  • Dallas, TX
  • NPI 1932257136
  NPD (past)

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

{
    "created_epoch": "1274659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326499200000",
    "number": "1942529425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1534 SIENNA CT",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752045242",
            "telephone_number": "267-997-8476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 LOMBARDY LN STE 100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752203315",
            "telephone_number": "214-350-5333",
            "fax_number": "214-350-8555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUGIANTO",
        "first_name": "LONG",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-24",
        "last_updated": "2012-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS038251",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "27450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mayssan Muftah, MD, MPH
• Arjmand Rasool Mufti, M.D.
• Orkun Muftuoglu, MD
• Waylon Mugartegui, CRNA
• Usman Mughni
• Sonja Mugnier
• Akilah Muhammad
• Hamad Muhammad, MD
• Hazim Muhammad
• Jamillah Muhammad

• Dentist in Dallas, TX
• Providers in Dallas, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2012; 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.