NPIMap

Organization Active NPI

Paradise Park Children'S Dental Clinic

  • Pediatric Dentistry
  • Las Vegas, NV
National Provider Identifier
1093983553
Registry record updated Feb 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
S686 Issued in NV
Legal business name
PARADISE PARK CHILDREN'S DENTAL CLINIC
Practice address
4770 Harrison Dr
Las Vegas, NV 89121-5563
Phone
(702) 432-3334
Fax
(702) 451-0583
NPI assigned
Feb 18, 2008
Organization subpart
Yes
Parent organization
CHILDREN'S DENTAL CARE INTERNATIONALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 18, 2008

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

Authorized official

Name
Windy Bailey
Title
Clinic Mananger
Phone
(702) 432-3334

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X S623 NV
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X S686 NV Primary

Addresses

Primary practice location

4770 Harrison Dr
Las Vegas, NV 89121-5563

Mailing address

4770 Harrison Dr
Las Vegas, NV 89121-5563
Phone (702) 432-3334

National Provider Directory

National Provider Directory
Tax ID family
Paradise Dental Clinic3 organizations share this tax ID, including this one
Part of
Paradise Dental Clinic

Other organizations with this tax ID 2

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

Locations

4770 Harrison Dr
Las Vegas, NV 89121
Phone (702) 432-3334

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1203292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203292800000",
    "number": "1093983553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4770 HARRISON DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891215563",
            "telephone_number": "702-432-3334",
            "fax_number": "702-451-0583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4770 HARRISON DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891215563",
            "telephone_number": "702-432-3334",
            "fax_number": "702-451-0583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARADISE PARK CHILDREN'S DENTAL CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHILDREN'S DENTAL CARE INTERNATIONAL",
        "enumeration_date": "2008-02-18",
        "last_updated": "2008-02-18",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "WINDY",
        "authorized_official_title_or_position": "CLINIC MANANGER",
        "authorized_official_telephone_number": "702-432-3334"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NV",
            "license": "S623",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NV",
            "license": "S686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 18, 2008; 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.