NPIMap

Organization Active NPI

Luckoor Queensridge Modern Dentistry, PC

  • General Practice Dentistry
  • Las Vegas, NV
National Provider Identifier
1154048304
Registry record updated Oct 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
LUCKOOR QUEENSRIDGE MODERN DENTISTRY, PC
Practice address
10040 Alta Drive Ste 100
Las Vegas, NV 89145
Phone
(702) 425-3060
Fax
(702) 425-3028
NPI assigned
Oct 27, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2022

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

Authorized official

Name
Saloni Luckoor, DMD
Title
Owner
Phone
(702) 425-3060

Specialties & licenses 1

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

Addresses

Primary practice location

10040 Alta Drive Ste 100
Las Vegas, NV 89145

Mailing address

PO Box 920050
Dallas, TX 75392-0050
Phone (714) 845-8890

Other names 1

  • Queensridge Modern Dentistry and Orthodontics Doing business as

National Provider Directory

National Provider Directory

Locations

10040 Alta Dr
Ste 100
Las Vegas, NV 89145
Phone (702) 425-3060

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": "1666828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666828800000",
    "number": "1154048304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920050",
            "telephone_number": "714-845-8890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10040 ALTA DRIVE STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89145",
            "telephone_number": "702-425-3060",
            "fax_number": "702-425-3028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUCKOOR QUEENSRIDGE MODERN DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-27",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-24",
        "status": "A",
        "authorized_official_last_name": "LUCKOOR",
        "authorized_official_first_name": "SALONI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-425-3060",
        "authorized_official_credential": "DMD"
    },
    "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": "Queensridge Modern Dentistry and Orthodontics",
            "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 Oct 27, 2022; 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.