MGM DENTAL PA – NPI #1396043576
Clinic/Center

MGM DENTAL PA is an AHC clinic located in MIAMI, FL. NPPES has assigned the NPI number 1396043576 to MGM DENTAL PA on March 11, 2011. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QD0000X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Dental

The NPI profile was previously updated about 8 years ago on Jul 02, 2018. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MGM DENTAL PA below.

NPI Profile for
MGM DENTAL PA

NPI Number
1396043576
Enumeration Date

(more than 15 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
MGM DENTAL PA
Primary location
15659 SW 88TH ST
MIAMI, FL 33196
Phone: (786) 558-7315 Fax: (786) 558-7318
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
MARIA MOGOLLON
OWNER
Phone: (786) 597-1636
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QD0000X
- Clinic/Center / Dental (Primary)		 FL DN20484
1223S0112X
- Dentist / Oral and Maxillofacial Surgery

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.