Shadow Creek Children's Dentistry and Orthodontics General Partnership

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

SHADOW CREEK CHILDREN'S DENTISTRY AND ORTHODONTICS GENERAL PARTNERSHIP

Doing business as

Shadow Creek Children's Dentistry and Orthodontics

Practice address

3410 E Centennial Pkwy Ste 110
North Las Vegas, NV 89081-5627

Phone

(702) 701-2563

NPI assigned

Jun 23, 2025

Last updated

Jun 23, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ryan JolleyNPI 1912304254

Title

Partner

Phone

(702) 701-2563

Specialties & licenses 2

Addresses

Other names 1

• Shadow Creek Children's Dentistry and Orthodontics Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ryan Jolley, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Las Vegas, NV
  • NPI 1912304254
  NPD Authorized official

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

{
    "created_epoch": "1750636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750636800000",
    "number": "1063309755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3196 S MARYLAND PKWY STE 307",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891092314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 E CENTENNIAL PKWY STE 110",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890815627",
            "telephone_number": "702-701-2563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADOW CREEK CHILDREN'S DENTISTRY AND ORTHODONTICS GENERAL PARTNERSHIP",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-23",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A",
        "authorized_official_last_name": "JOLLEY",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "702-701-2563"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shadow Creek Children's Dentistry and Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Leilani Fuentes Sevilla
• Mauriecia Sewell
• Sherri Lynn Seyfert
• Christina Sgro
• V. Michelle Shade-Shepherd
• Shadow Emergency Physicians PLLC
• Shadow Emergency Physicians PLLC
• Joan Raynea Shaffer
• Muhammad Shafique, MD
• Dishant Dilipbhai Shah, D.D.S

• Pediatric Dentistry in North Las Vegas, NV
• Providers in North 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 Jun 23, 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.