Abraza Dental Group LLC

Primary specialty

DentistTaxonomy code 122300000X

License

6743 Issued in NV

Legal business name

ABRAZA DENTAL GROUP LLC

Practice address

5642 S Eastern Ave
Suite B
Las Vegas, NV 89119-2375

Phone

(702) 456-0005

NPI assigned

Jun 14, 2016

Last updated

Jun 15, 2016By 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

Wyatt Stott Dannels, DDS

Title

DDS

Phone

(702) 456-0005

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Gene Ryan Tunney, DDS

  • General Practice Dentistry
  • Bethlehem, PA
  • NPI 1821587643
  NPD (past)
• Benjamin Zike, DDS

  • General Practice Dentistry
  • Tillamook, OR
  • NPI 1679097448
  NPD (past)

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

{
    "created_epoch": "1465862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465948800000",
    "number": "1073963757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5642 S EASTERN AVE",
            "address_2": "SUITE B",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891192375",
            "telephone_number": "702-456-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5642 S EASTERN AVE",
            "address_2": "SUITE B",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891192375",
            "telephone_number": "702-456-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABRAZA DENTAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-14",
        "last_updated": "2016-06-15",
        "status": "A",
        "authorized_official_last_name": "DANNELS",
        "authorized_official_first_name": "WYATT",
        "authorized_official_middle_name": "STOTT",
        "authorized_official_title_or_position": "DDS",
        "authorized_official_telephone_number": "702-456-0005",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NV",
            "license": "6743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Abrams
• James Abrams
• Laurie Beth Abrams, D.M.D
• Linda Abrams
• Abraxas Center LLC
• Vilma Elena Abrego-Ortiz
• Ana Abrego
• Jocelyn Abrego
• Julio Abrego
• Bernadette Payumo Abregunda, PMHNP

• Dentist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Dentist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2016; 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.