NPIMap

Organization Active NPI

Radiant Smiles Series 2 LLC

  • General Practice Dentistry
  • Las Vegas, NV
National Provider Identifier
1104132281
Registry record updated Aug 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4725 Issued in NV
Legal business name
RADIANT SMILES SERIES 2 LLC
Practice address
8961 W Sahara Ave Ste 108
Las Vegas, NV 89117-5831
Phone
(702) 360-4800
Fax
(702) 360-2846
NPI assigned
Aug 26, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2010

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

Authorized official

Name
Mr. David C Gonzalez
Title
Director
Phone
(702) 360-4800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 4725 NV Primary

Addresses

Primary practice location

8961 W Sahara Ave Ste 108
Las Vegas, NV 89117-5831

Mailing address

8961 W Sahara Ave Ste 108
Las Vegas, NV 89117-5831
Phone (702) 360-4800

National Provider Directory

National Provider Directory

Locations

8961 W Sahara Ave
Ste 108
Las Vegas, NV 89117
Phone (702) 360-4800

Practitioners & affiliated clinicians

Practitioners 3

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": "1282780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282780800000",
    "number": "1104132281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8961 W SAHARA AVE STE 108",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891175831",
            "telephone_number": "702-360-4800",
            "fax_number": "702-360-2846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8961 W SAHARA AVE STE 108",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891175831",
            "telephone_number": "702-360-4800",
            "fax_number": "702-360-2846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIANT SMILES SERIES 2 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-26",
        "last_updated": "2010-08-26",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "702-360-4800",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "4725",
            "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 Aug 26, 2010; 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.