NPIMap

Organization Active NPI

Canyon Dental Implant Center LLC

Doing business as Canyon Dental Implants & Dentures

  • Dental Clinic/Center
  • Las Vegas, NV
National Provider Identifier
1073052072
Registry record updated Feb 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
CANYON DENTAL IMPLANT CENTER LLC
Doing business as
Canyon Dental Implants & Dentures
Practice address
3635 S Town Center Dr
Las Vegas, NV 89135-3017
Phone
(702) 660-5576
Fax
(702) 660-5590
NPI assigned
Feb 23, 2017
Last updated
Feb 23, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2017

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

Authorized official

Name
Dr. Jesse Falk, DMDNPI 1285924605
Title
Member
Phone
(702) 660-5574

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

3635 S Town Center Dr
Las Vegas, NV 89135-3017

Mailing address

6200 N Durango Dr Ste 100
Las Vegas, NV 89149-3916
Phone (702) 660-5574

Other names 1

  • Canyon Dental Implants & Dentures Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Canyon Dental Implant Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

3635 S Town Center Dr
Las Vegas, NV 89135
Phone (702) 660-5574

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1487808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487808000000",
    "number": "1073052072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 N DURANGO DR STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891493916",
            "telephone_number": "702-660-5574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3635 S TOWN CENTER DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891353017",
            "telephone_number": "702-660-5576",
            "fax_number": "702-660-5590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANYON DENTAL IMPLANT CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-23",
        "last_updated": "2017-02-23",
        "status": "A",
        "authorized_official_last_name": "FALK",
        "authorized_official_first_name": "JESSE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "702-660-5574",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Canyon Dental Implants & Dentures",
            "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 Feb 23, 2017; 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.