Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mirage Center Outpatient Surgery

Organization Oral & Maxillofacial Surgery (D.M.D.) · NPI 1245128917

Mirage Center Outpatient Surgery is an Oral & Maxillofacial Surgery (D.M.D.) in Rancho Mirage, California. Registered with an NPI since 2025.

In the registry since
2025

Practice location Address checks out

39935 Vista Del Sol Ste 101
Rancho Mirage, CA 92270-3211
Phone: (760) 413-8182
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral & Maxillofacial Surgery (D.M.D.) (primary) Taxonomy 204E00000X

Record details

NPI number1245128917
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Justyn Mawby — Admin/Or Supervisor · (760) 485-9636
NPI enumeratedJune 24, 2025
Last updated in NPPESJune 24, 2025
Certification dateJune 24, 2025
Mailing address39935 Vista Del Sol Ste 206, Rancho Mirage, CA 92270-3211

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