NPIMap

Organization Active NPI

Ada Nevada Dental LLC

  • General Practice Dentistry
  • Las Vegas, NV
National Provider Identifier
1154084309
Registry record updated Oct 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
ADA NEVADA DENTAL LLC
Practice address
5230 Boulder Hwy Ste 130
Las Vegas, NV 89122-6079
Phone
(702) 851-6724
NPI assigned
Oct 14, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2021

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

Authorized official

Name
Gregory Walter Greenwood, DMD,PHARMD,MACSD
Title
Clinical Director
Phone
(504) 952-0344

Specialties & licenses 1

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

Addresses

Primary practice location

5230 Boulder Hwy Ste 130
Las Vegas, NV 89122-6079

Mailing address

5230 Boulder Hwy Ste 130
Las Vegas, NV 89122-6079
Phone (702) 851-6724

National Provider Directory

National Provider Directory
Tax ID family
Ada Nevada Dental LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1634169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634169600000",
    "number": "1154084309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5230 BOULDER HWY STE 130",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891226079",
            "telephone_number": "702-851-6724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5230 BOULDER HWY STE 130",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891226079",
            "telephone_number": "702-851-6724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADA NEVADA DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-14",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A",
        "authorized_official_last_name": "GREENWOOD",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "WALTER",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "504-952-0344",
        "authorized_official_credential": "DMD,PHARMD,MACSD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "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 Oct 14, 2021; 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.