Organization Active NPI

Paradise LV Nielson PDC PLLC

  • General Practice Dentistry
  • Las Vegas, NV
National Provider Identifier
1053287144
Registry record updated Oct 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
PARADISE LV NIELSON PDC PLLC
Practice address
2458 E Russell Rd Ste B
Las Vegas, NV 89120-2475
Phone
(702) 798-4595
NPI assigned
Oct 15, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2025

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

Authorized official

Name
Jaxon Downing
Title
Credentialing Specialist
Phone
(801) 305-3460

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

2458 E Russell Rd Ste B
Las Vegas, NV 89120-2475

Mailing address

727 E Utah Valley Dr
American Fork, UT 84003-3345
Phone (801) 305-3460

National Provider Directory

National Provider Directory

Locations

2458 E Russell Rd
Ste B
Las Vegas, NV 89120
Phone (702) 798-4595

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1760486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760486400000",
    "number": "1053287144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "727 E UTAH VALLEY DR",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840033345",
            "telephone_number": "801-305-3460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2458 E RUSSELL RD STE B",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891202475",
            "telephone_number": "702-798-4595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARADISE LV NIELSON PDC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-15",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A",
        "authorized_official_last_name": "DOWNING",
        "authorized_official_first_name": "JAXON",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "801-305-3460"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 15, 2025; 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.