Complete Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4759 Issued in NV

Legal business name

COMPLETE DENTAL LLC

Practice address

2625 S Rainbow Blvd
#D100
Las Vegas, NV 89146-5198

Phone

(702) 227-5800

Fax

(702) 227-5801

NPI assigned

Mar 27, 2012

Organization subpart

No

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

Authorized official

Name

Jong Sook Jin, D.D.SNPI 1720053374

Title

Manager

Phone

(702) 227-5800

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Jong S Jin, DDS

  • General Practice Dentistry
  • Las Vegas, NV
  • NPI 1720053374
  NPD (past) Authorized official

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

{
    "created_epoch": "1332806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332806400000",
    "number": "1144596800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 S RAINBOW BLVD",
            "address_2": "#D100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891465198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 S RAINBOW BLVD",
            "address_2": "#D100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891465198",
            "telephone_number": "702-227-5800",
            "fax_number": "702-227-5801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-27",
        "last_updated": "2012-03-27",
        "status": "A",
        "authorized_official_last_name": "JIN",
        "authorized_official_first_name": "JONG",
        "authorized_official_middle_name": "SOOK",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "702-227-5800",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "4759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• General Practice Dentistry in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2012; 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.