NPIMap

Organization Active NPI

Shiva Keshmiri DDS a Professional Corporation

  • General Practice Dentistry
  • Las Vegas, NV
National Provider Identifier
1063929172
Registry record updated Jan 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4514 Issued in NV
Legal business name
SHIVA KESHMIRI DDS A PROFESSIONAL CORPORATION
Doing business as
Las Vegas Smile Center
Practice address
6600 W. Charleston Blvd
#103
Las Vegas, NV 89146
Phone
(702) 433-6825
Fax
(702) 821-1499
NPI assigned
Jan 10, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2018

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

Authorized official

Name
Shiva Keshmiri, DDS
Title
Doctor/Owner
Phone
(702) 257-9090

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 4514 NV Primary

Addresses

Primary practice location

6600 W. Charleston Blvd
#103
Las Vegas, NV 89146

Mailing address

4121 W. Sahara Ave
Las Vegas, NV 89102
Phone (702) 257-9090

Other names 1

  • Las Vegas Smile Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Shiva Keshmiri DDS a Professional Corporation3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

6600 W Charleston Blvd
Ste 103
Las Vegas, NV 89146
Phone (702) 433-6825

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": "1515542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515542400000",
    "number": "1063929172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4121 W. SAHARA AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89102",
            "telephone_number": "702-257-9090",
            "fax_number": "702-873-7263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 W. CHARLESTON BLVD",
            "address_2": "#103",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89146",
            "telephone_number": "702-433-6825",
            "fax_number": "702-821-1499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHIVA KESHMIRI DDS A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-10",
        "last_updated": "2018-01-10",
        "status": "A",
        "authorized_official_last_name": "KESHMIRI",
        "authorized_official_first_name": "SHIVA",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "702-257-9090",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "4514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Las Vegas Smile Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 10, 2018; 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.