NPIMap

Organization Active NPI

Michael R Wanlass DDS LTD

  • Prosthetic/Orthotic Supplier
  • Las Vegas, NV
National Provider Identifier
1154786929
Registry record updated Dec 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
2287 Issued in NV
Legal business name
MICHAEL R WANLASS DDS LTD
Practice address
2625 S Rainbow Blvd
Suite C-100
Las Vegas, NV 89146-5198
Phone
(702) 367-4412
NPI assigned
Dec 22, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2015

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

Authorized official

Name
Michael Wanlass, DDS
Title
President
Phone
(702) 367-4412

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X 2287 NV Primary

Addresses

Primary practice location

2625 S Rainbow Blvd
Suite C-100
Las Vegas, NV 89146-5198

Mailing address

2625 S Rainbow Blvd
Suite C-100
Las Vegas, NV 89146-5198
Phone (702) 367-4412

National Provider Directory

National Provider Directory

Locations

2625 S Rainbow Blvd
Ste C100
Las Vegas, NV 89146
Phone (702) 367-4412

Practitioners & affiliated clinicians

Practitioners 2

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": "1450742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450742400000",
    "number": "1154786929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 S RAINBOW BLVD",
            "address_2": "SUITE C-100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891465198",
            "telephone_number": "702-367-4412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 S RAINBOW BLVD",
            "address_2": "SUITE C-100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891465198",
            "telephone_number": "702-367-4412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL R WANLASS DDS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-22",
        "last_updated": "2015-12-22",
        "status": "A",
        "authorized_official_last_name": "WANLASS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-367-4412",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NV",
            "license": "2287",
            "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 Dec 22, 2015; 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.