NPIMap

Organization Active NPI

Absolute Dental Eastern, Inc

  • General Practice Dentistry
  • Las Vegas, NV
National Provider Identifier
1134218910
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4566 Issued in NV
Legal business name
ABSOLUTE DENTAL EASTERN, INC
Practice address
9400 S Eastern Ave
Suite 101
Las Vegas, NV 89123-7936
Phone
(702) 456-0009
Fax
(702) 458-0009
NPI assigned
Oct 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Leonid BanchikNPI 1558450965
Title
Owner
Phone
(702) 456-0009

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 4566 NV Primary

Addresses

Primary practice location

9400 S Eastern Ave
Suite 101
Las Vegas, NV 89123-7936

Mailing address

9400 S Eastern Ave
Suite 101
Las Vegas, NV 89123-7936
Phone (702) 456-0009

National Provider Directory

National Provider Directory

Locations

9400 S Eastern Ave
Ste 101
Las Vegas, NV 89123
Phone (702) 456-0009

Practitioners & affiliated clinicians

Practitioners 5

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": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1134218910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9400 S EASTERN AVE",
            "address_2": "SUITE 101",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891237936",
            "telephone_number": "702-456-0009",
            "fax_number": "702-458-0009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9400 S EASTERN AVE",
            "address_2": "SUITE 101",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891237936",
            "telephone_number": "702-456-0009",
            "fax_number": "702-458-0009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABSOLUTE DENTAL EASTERN, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BANCHIK",
        "authorized_official_first_name": "LEONID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-456-0009",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "4566",
            "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 22, 2020; 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.