Providence Orthodontics Dhillon PLLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

S681 Issued in NV

Legal business name

PROVIDENCE ORTHODONTICS DHILLON PLLC

Practice address

7181 N Hualapai Way
105
Las Vegas, NV 89166-1115

Phone

(702) 852-1818

Fax

(702) 947-5088

NPI assigned

Feb 24, 2017

Organization subpart

No

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

Authorized official

Name

Tiffany Lorick

Title

Credentialing Specialist

Phone

(704) 806-3632

Specialties & licenses 1

Addresses

Other names 3

• Buffalo 215 Dental & Orthodontics Doing business as
• Edge Dental & Orthodontics Doing business as
• West Henderson Dental & Orthodontics Doing business as

Locations

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

{
    "created_epoch": "1487894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676851200000",
    "number": "1124568043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7181 N HUALAPAI WAY",
            "address_2": "105",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891661115",
            "telephone_number": "702-852-1818",
            "fax_number": "702-947-5088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7181 N HUALAPAI WAY",
            "address_2": "105",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891661115",
            "telephone_number": "702-852-1818",
            "fax_number": "702-947-5088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE ORTHODONTICS DHILLON PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-24",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A",
        "authorized_official_last_name": "LORICK",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "704-806-3632"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NV",
            "license": "S681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Buffalo 215 Dental & Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Edge Dental & Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Edge Dental & Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "West Henderson Dental & Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Providence Dental Dhillon PLLC
• Providence Dental Dhillon PLLC
• Providence Healthcare of Nevada LLC
• Providence Hospice of Las Vegas LLC
• Providence Mental Health LLC
• Provider Profiles, Inc.
• Provisions HHS, Inc
• Byron Alonzo Provost Jr.
• Shelby Danelle Prows
• Peggy Ann Pruchnicki, NP

• Orthodontics and Dentofacial Orthopedics Dentistry in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2023; 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.