Individual provider Active NPI

Christopher James McCormick, DDS

  • Dentist
  • Henderson, NV
National Provider Identifier
1053006007
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8250 Issued in NV
Practice address
2570 Wigwam Pkwy Ste 110
Henderson, NV 89074-6225
Phone
(702) 757-3399
NPI assigned
Apr 6, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 8250 NV Primary

Addresses

Primary practice location

2570 Wigwam Pkwy Ste 110
Henderson, NV 89074-6225

Mailing address

3930 Paradise Rd Unit 317
Las Vegas, NV 89169-4815
Phone (702) 754-8240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250925000723 NV Order and Referring Only - DentistPractitioner - Dentist 3274038716

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8250NVMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Velayo Green Valley Smiles Dentistry, PC CurrentSince Aug 17, 2025 Accepting new patients

Locations

2570 Wigwam Pkwy
Ste 110
Henderson, NV 89074
Phone (702) 757-3399

Organizations & group practices 1

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": "1680739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1053006007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3930 PARADISE RD UNIT 317",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891694815",
            "telephone_number": "702-754-8240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2570 WIGWAM PKWY STE 110",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890746225",
            "telephone_number": "702-757-3399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMICK",
        "first_name": "CHRISTOPHER",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-06",
        "last_updated": "2025-08-12",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NV",
            "license": "8250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.