Active NPI
Prashanti Bollu, D.M.D., M.S., M.B.A.
- Orthodontics and Dentofacial Orthopedics Dentistry
- Henderson, NV
National Provider Identifier
1083849178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- S3-228
- Practice address
- 1450 W Horizon Ridge Pkwy Ste B308-309
Henderson, NV 89012-4477 - Phone
- (702) 703-0102
- Fax
- (702) 723-6773
- NPI assigned
- May 19, 2009
- Last updated
- Feb 27, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | S3-228 | NV | Primary |
Addresses
Primary practice location
1450 W Horizon Ridge Pkwy Ste B308-309
Henderson, NV 89012-4477
Mailing address
771 Glowing Horizon St
Henderson, NV 89052-8743
Phone (617) 849-0751
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Business Administration, Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S3-228 | NV | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| P&G Smiles LLC | Orthodontics and Dentofacial Orthopedics | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba P&G Orthodontics
- Orthodontics and Dentofacial Orthopedics Dentistry
- Henderson, NV
- NPI 1508453648
-
- Orthodontics and Dentofacial Orthopedics Dentistry
- Las Vegas, NV
- NPI 1689529380
-
dba P&G Orthodontics
- Orthodontics and Dentofacial Orthopedics Dentistry
- Las Vegas, NV
- NPI 1962357665
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1242691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1772150400000",
"number": "1083849178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "771 GLOWING HORIZON ST",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890528743",
"telephone_number": "617-849-0751"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1450 W HORIZON RIDGE PKWY STE B308-309",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890124477",
"telephone_number": "702-703-0102",
"fax_number": "702-723-6773"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLLU",
"first_name": "PRASHANTI",
"name_prefix": "Dr.",
"credential": "D.M.D., M.S., M.B.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-05-19",
"last_updated": "2026-02-27",
"certification_date": "2026-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "NV",
"license": "S3-228",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Henderson, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.