Anthem Village Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

132074 Issued in NV

Legal business name

ANTHEM VILLAGE DENTAL LLC

Practice address

2571 Anthem Village Dr
Suite #5
Henderson, NV 89052-5508

Phone

(702) 454-7704

Fax

(702) 454-0200

NPI assigned

Jan 18, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Robert Wilford Nisson, DDS

Title

Officer in Corporation

Phone

(702) 454-7704

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043362981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2571 ANTHEM VILLAGE DR",
            "address_2": "SUITE #5",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890525508",
            "telephone_number": "702-454-7704",
            "fax_number": "702-454-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2571 ANTHEM VILLAGE DR",
            "address_2": "SUITE #5",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890525508",
            "telephone_number": "702-454-7704",
            "fax_number": "702-454-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTHEM VILLAGE DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NISSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "WILFORD",
        "authorized_official_title_or_position": "OFFICER IN CORPORATION",
        "authorized_official_telephone_number": "702-454-7704",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "132074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthem Dental Inc
• Anthem Hills Dental
• Anthem Hospice Inc
• Anthem Periodontics and Dental Implants
• Anthem Physical Therapy, Inc. (Synergy Physical Therapy)
• Anthony M Ricciardi Jr LTD Inc. (Foot, Ankle and Hand Center of Las Vegas)
• Anthony Quinn Psychiatry PLLC
• Roger Anthony
• Lindsay Rochelle Anton
• Alexa Ann Antonopoulos, OT

• General Practice Dentistry in Henderson, NV
• Providers in Henderson, NV by specialty
• General Practice Dentistry in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.