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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 30 days.

MOGOLLON FAMILY DENTISTRY
NPI 1164344834
Dentist - General Practice in Overgaard, AZ

Active since July 27, 2026
3367 BUCKSKIN RD # 100, OVERGAARD, AZ 85933(928) 535-5886(928) 535-5887 Get Directions Write a Review

NPPES record added: July 27, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mogollon Family Dentistry NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MOGOLLON FAMILY DENTISTRY (NPI 1164344834) is a healthcare organization registered as a general practice in Overgaard, Arizona and active in the NPI registry since July 2026. The organization lists Jeffrey Andersen, Dentist/ Owner, as its authorized official.

NPPES Registry Identity

NPI1164344834
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameMOGOLLON FAMILY DENTISTRY
Location Address3367 BUCKSKIN RD # 100Overgaard, AZ 85933
Mailing AddressPo Box 100Overgaard, AZ 85933-0100 · (928) 535-5886 · Fax (928) 535-5887
Phone(928) 535-5886
Fax(928) 535-5887
Organization SubpartNo
Authorized OfficialJeffrey AndersenDentist/ Owner · (928) 535-5886
Enumeration DateJuly 27, 2026
NPPES CertifiedJuly 27, 2026
✔ NPI 1164344834 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition
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.
3367 BUCKSKIN RD # 100, Overgaard, AZ 85933
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mogollon Family Dentistry's NPI number?

The NPI number for Mogollon Family Dentistry is 1164344834. It was assigned to this organization in the NPPES registry on July 27, 2026.

Where is Mogollon Family Dentistry located?

Mogollon Family Dentistry is located at 3367 Buckskin Rd # 100, Overgaard, AZ 85933. The listed phone number is (928) 535-5886.

What is Mogollon Family Dentistry's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Mogollon Family Dentistry was last updated on July 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.