NPIMap

Organization Active NPI

Watanabe Town Center Dental Group, Professional Corporation

  • General Practice Dentistry
  • Las Vegas, NV
National Provider Identifier
1104954833
Registry record updated Aug 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
WATANABE TOWN CENTER DENTAL GROUP, PROFESSIONAL CORPORATION
Practice address
7125 N Durango Dr
Las Vegas, NV 89149-4466
Phone
(702) 658-2311
Fax
(702) 658-8811
NPI assigned
Mar 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2013

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

Authorized official

Name
Dr. Lynda Watanabe
Title
Owner Doctor
Phone
(702) 658-2311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

7125 N Durango Dr
Las Vegas, NV 89149-4466

Mailing address

2860 Michelle Drive
2ND Floor
Irvine, CA 92606-1009
Phone (714) 845-8890

Other names 1

  • MONTECITO TOWN CENTER DENTAL GROUP Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
29D2264117Montecito Town Center Dental Group7125 N Durango Drive, Las Vegas, NV 89149Certificate of waiverJul 10, 2026

National Provider Directory

National Provider Directory

Locations

7125 N Durango Dr
Las Vegas, NV 89149
Phone (702) 658-2311

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375401600000",
    "number": "1104954833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 MICHELLE DRIVE",
            "address_2": "2ND FLOOR",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926061009",
            "telephone_number": "714-845-8890",
            "fax_number": "949-474-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7125 N DURANGO DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891494466",
            "telephone_number": "702-658-2311",
            "fax_number": "702-658-8811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATANABE TOWN CENTER DENTAL GROUP, PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-02",
        "last_updated": "2013-08-02",
        "status": "A",
        "authorized_official_last_name": "WATANABE",
        "authorized_official_first_name": "LYNDA",
        "authorized_official_title_or_position": "OWNER DOCTOR",
        "authorized_official_telephone_number": "702-658-2311",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MONTECITO TOWN CENTER DENTAL GROUP",
            "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 Aug 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.