MOHAVE DENTAL ASSOCIATES PC (NPI# 1942266846) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942266846 |
| Entity Type | Organization |
| Organization Name | MOHAVE DENTAL ASSOCIATES PC |
| Practice Address |
4601 Stockton Hill Road Kingman AZ 86409 |
| Practice Telephone | 9287573225 |
| Practice Fax Number | 9287577477 |
| Mailing Telephone | 9287573225 |
| Mailing Fax Number | 9287577477 |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2012-02-02 |
| Authorized Official Name | MR. CLARK EARL MELSTROM (OWNER) |
| Authorized Official Telephone | 9287573225 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 2714 | AZ | Dental Providers |
| Street Address |
4601 STOCKTON HILL ROAD |
| City | KINGMAN |
| State | AZ |
| Zip Code | 86409 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437695731 | Medical Laboratory Specialty, Inc | Clinical Medical Laboratory | 3636 St, Kingman, AZ 86409 | 2017-01-10 |
| 1003219007 | Premier Home Health Agency | Home Health | 3555 Western Ave, Kingman, AZ 86409 | 2014-10-03 |
| 1558774984 | Fernando Velez | Pharmacist | 2003 Roy Rogers Way, Kingman, AZ 86409 | 2014-06-03 |
| 1013227834 | Route 66 Cab Inc | Taxi | 3595 E Us Highway 66, Kingman, AZ 86409 | 2010-10-14 |
| 1740503374 | Route 66 Cab Inc. | Taxi | 3595 East Hwy 66, Kingman, AZ 86409 | 2010-03-10 |
| 1649409145 | Arizona Cvs Stores, L.L.C. | Durable Medical Equipment & Medical Supplies | 3501 Stockton Hill Rd, Kingman, AZ 86409 | 2009-07-07 |
| 1790922896 | Jack Cheng-tsung Hou | Urology | 1739 E Beverly Ave Ste 106, Kingman, AZ 86409 | 2009-01-12 |
| 1710184726 | Michele F Epstein | Internal Medicine | 3571 N Moore Street, Kingman, AZ 86409 | 2007-07-02 |
| 1013118306 | Conchita O Mercado | Dentist | 1101 Riata Valley Rd, Kingman, AZ 86409 | 2007-05-31 |
| 1366585945 | Deering Therapy Services Ltd | Occupational Therapist | 1841 Morrow Ave, Kingman, AZ 86409 | 2007-02-14 |
| Find all providers in zip 86409 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447865480 | Luke Michael Mangelsdorf | Dentist | 2249 Hualapai Mountain Rd Ste 1, Kingman, AZ 86401-8321 | 2020-09-15 |
| 1336645340 | Just for Kids Dental Group Kingman, Pllc | Dentist | 2401 N Stockton Hill Rd Ste 1, Kingman, AZ 86401-4189 | 2018-03-30 |
| 1982150264 | Jesse Isaac Mangelsdorf | Dentist | 2249 Hualapai Mountain Rd, Suite A, Kingman, AZ 86401-8321 | 2016-08-28 |
| 1821436387 | Clark E Melstrom | Dentist | 4601 Stockton Hill Rd., Kingman, AZ 86409-1759 | 2013-06-06 |
| 1407091440 | Nomaan Tariq | Dentist | 3940 Raymond Ave, Kingman, AZ 86409-0930 | 2008-12-04 |
| 1447415799 | Kelly Marie Bradley | Dentist | 1848 Hope Ave, Suite #2, Kingman, AZ 86401 | 2008-07-25 |
| 1669664553 | Theodore S Kimball IIi | Dentist | 2065 Airway Ave, Suite B, Kingman, AZ 86409-3656 | 2007-08-14 |
| 1275753626 | Tori Sandoval | Dentist | 2535 Hualapai Mountain Rd Ste E, Kingman, AZ 86401-5412 | 2007-04-26 |
| 1205931011 | Gary James Lacaze | Dentist | 1616 Stockton Hill Rd, Kingman, AZ 86401 | 2006-09-14 |
| 1538147236 | Richard E Davis | Dentist | 126 West Ave B, Kingman, KS 67068 | 2006-01-04 |
| Find all providers in KINGMAN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.