Charlene Mo, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

S6-188 Issued in NV

Practice address

2250 S Rancho Dr Ste 205
Las Vegas, NV 89102-4456

Phone

(702) 291-2031

NPI assigned

Nov 2, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• New Mexico Dentistry Prada, PLLC

  • Dentist
  • Albuquerque, NM
  • NPI 1376215731
  NPD
• Southern Nevada Specialty Prada, PLLC

  • Pediatric Dentistry
  • Las Vegas, NV
  • NPI 1275998270
  NPD (past)

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

{
    "created_epoch": "1541116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1013485523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 S RANCHO DR STE 205",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891024456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 S RANCHO DR STE 205",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891024456",
            "telephone_number": "702-291-2031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Shadow Ln",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891064124",
            "country_code": "US",
            "telephone_number": "702-774-2674",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MO",
        "first_name": "CHARLENE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-02",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NV",
            "license": "S6-188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karine Mnatsakanyan
• Maik Mnatsakanyan
• Tsovinar Mnatsakanyan
• MNJ Corporation
• Mo Pro Services LLC
• Kevin Mo, DO
• Moa Family Care
• Shanee Moas, M.S., MFT-INTERN
• Tempest Moats
• Carmel Moazez, M.D.

• Pediatric Dentistry in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Pediatric Dentistry in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2020; 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.