J H Daulat DO PC – Dermatology Physician

Key facts

NPI: 1023554185
Entity type: Organization (NPI type 2)
Primary specialty: Dermatology Physician 207N00000X
License: 363 (NV)
Legal business name: J H DAULAT DO PC
Practice address: 340 Falcon Ridge Pkwy Ste 400-404
Mesquite, NV 89027-8850
Phone: (702) 346-5510
Fax: (702) 346-2557
NPI assigned: Jan 13, 2017
Organization subpart: No

Authorized official

Name: Jaldeep H Daulat, DO NPI 1114949492
Title: Owner
Phone: (702) 346-5510

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

J H Daulat DO PC Dermatology Physician · Pahrump, NV · NPI 1821534983

NPD tax ID

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Jaldeep H Daulat, DO MOHS-Micrographic Surgery Physician · Las Vegas, NV · NPI 1114949492

NPD (past) Authorized official DERMATOLOGY
Feroza Thompson, PA Physician Assistant · Mesquite, NV · NPI 1891940698

NPD
Nicholas Anthony Benites, PA-C Physician Assistant · Las Vegas, NV · NPI 1174882807

NPD (past)
Michael Roos, PA Medical Physician Assistant · Pahrump, NV · NPI 1477655223

NPD (past) DERMATOLOGY
Greg Robert Jacobsen, M.D. Dermatology Physician · St George, UT · NPI 1811105745

NPD (past) DERMATOLOGY

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
29D2128619	Mohave Dermatology-Mesquite 340 Falcon Ridge Pkwy Ste 400, Mesquite, NV 89027	Compliance	Aug 10, 2027

National Provider Directory

Tax ID family: J H Daulat DO PC (2 organizations share this tax ID)

Locations

340 Falcon Ridge Pkwy
Ste 400404
Mesquite, NV 89027
Phone (702) 346-5510

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Dermatology Physician Group: 193400000X SINGLE SPECIALTY GROUP	207N00000X	363	NV	Yes

Addresses

Primary practice location

340 Falcon Ridge Pkwy Ste 400-404
Mesquite, NV 89027-8850

Mailing address

9750 W Skye Canyon Park Dr
Suite 160 Box 103
Las Vegas, NV 89166
Phone (702) 683-1727

Other names

MOHAVE DERMATOLOGY Doing business as

Electronic endpoints

Type	Endpoint	Use	Affiliation
CONNECT URL	MohaveDerm.ema.md

Other providers in Mesquite, NV

All providers in Mesquite, NV · Dermatology Physician in Nevada

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 28, 2022. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.