HENDERSON MODERN DENTISTRY NPI 1083098032

NPI Information

HENDERSON MODERN DENTISTRY is a general practice dentist in Henderson, NV. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. HENDERSON MODERN DENTISTRY NPI is 1083098032. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

386 W LAKE MEAD PKWY
SUITE 100
HENDERSON, NV
ZIP 89015-417
Phone: (702) 464-3090

The provider's authorized official is Cody Mugleston .
The authorized official title is Owner Doctor and has the following contact phone number (702) 464-3090.

The CLIA number assigned to this NPI record is 29D2099745 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/18/2015 and was last updated on 7/18/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.