LUMINA LLC NPI 1003418369

Clinic/Center (Dental) in Mangilao, GU

NPI 1003418369 Organization Clinic/Center Dental

About LUMINA LLC

Lumina Llc is a provider established in Mangilao, Guam specializing in clinic/center (dental) . The NPI number of Lumina Llc is 1003418369 and was assigned on November 2020. The practitioner's primary taxonomy code is 261QD0000X. The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Dr. Sarah Lee Clegg Dds (Owner)

NPI

1003418369

Provider NameLUMINA LLC
Provider Location Address353 ROUTE 10 STE 101 MANGILAO, GU 96913
Provider Mailing AddressPO BOX 9868 TAMUNING, GU 96931
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date11-12-2020
Last Update Date11-13-2020


Primary Taxonomy

Taxonomy Code261QD0000X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
SpecializationDental

Business Address

LUMINA LLC
353 ROUTE 10 STE 101
MANGILAO, GU
ZIP 96913
Phone: (671) 969-4242

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Mailing Address

LUMINA LLC
PO BOX 9868
TAMUNING, GU
ZIP 96931
Phone: (510) 283-3460



Authorized Official

Authorized Official NameDR. SARAH LEE CLEGG DDS
Authorized Official TitleOWNER
Authorized Official Phone(510) 283-3460

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.