Individual provider Active NPI

Jeffrey T Pearson

  • General Practice Dentistry
  • Las Vegas, NV
National Provider Identifier
1013272624
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7370 Issued in NV
Practice address
7595 W Washington Ave Ste 170
Las Vegas, NV 89128-4345
Phone
(702) 444-2494
Fax
(702) 505-4448
NPI assigned
Jul 10, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D008428 AZ
General Practice Dentistry 1223G0001X 7370 NV Primary

Addresses

Primary practice location

7595 W Washington Ave Ste 170
Las Vegas, NV 89128-4345

Mailing address

7595 W Washington Ave Ste 170
Las Vegas, NV 89128-4345
Phone (702) 444-2494

Other practice location 1

6348 S Rainbow Blvd Ste 110
Las Vegas, NV 89118-3237
Phone (725) 207-9797

Other identifiers 2

IdentifierTypeStateIssuer
1134345937MedicaidAZ
670703MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D008428AZMDDentist
7370NVMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Zahn Group LLC CurrentSince Feb 1, 2022 Accepting new patients
The Emergency Dentists LLC Current Accepting new patients

Locations

7595 W Washington Ave
Ste 170
Las Vegas, NV 89128
Phone (702) 444-2494

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1341878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1013272624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7595 W WASHINGTON AVE STE 170",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891284345",
            "telephone_number": "702-444-2494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7595 W WASHINGTON AVE STE 170",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891284345",
            "telephone_number": "702-444-2494",
            "fax_number": "702-505-4448"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6348 S Rainbow Blvd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891183237",
            "country_code": "US",
            "telephone_number": "725-207-9797",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "JEFFREY",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-10",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D008428",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "7370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134345937",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "670703",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.