Active NPI
Glosman Dental Group, LTD
Doing business as Dentalville
- Dentist
- Las Vegas, NV
National Provider Identifier
1164603502
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 3580
- Legal business name
- GLOSMAN DENTAL GROUP, LTD
- Doing business as
- Dentalville
- Practice address
- 5060 S Fort Apache Rd
#160
Las Vegas, NV 89148-1731 - Phone
- (702) 851-8200
- Fax
- (702) 851-8201
- NPI assigned
- Nov 14, 2007
- Last updated
- Jun 7, 2013
- Organization subpart
- Yes
- Parent organization
- GLOSMAN DENTAL GROUP, LTD
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Monique R Glosman, DDS
- Title
- Chief of Staff
- Phone
- (310) 480-2307
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 3580 | NV | Primary |
Addresses
Primary practice location
5060 S Fort Apache Rd
#160
Las Vegas, NV 89148-1731
Mailing address
833 W Whittier Blvd
Montebello, CA 90640-4735
Phone (323) 266-1000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100512440 | Medicaid | NV |
Other names 1
- Dentalville
National Provider Directory
National Provider Directory- Tax ID family
- Glosman Dental Group LTD
- Part of
- Glosman Dental Group LTD
Other organizations with this tax ID 5
Organizations that report the same tax identification number in the National Provider Directory.
-
- Dentist
- Los Angeles, CA
- NPI 1871772368
Locations
5060 S Fort Apache Rd
Ste 160
Las Vegas, NV 89148
Phone (702) 851-8200
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1194998400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1370563200000",
"number": "1164603502",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "833 W WHITTIER BLVD",
"city": "MONTEBELLO",
"state": "CA",
"postal_code": "906404735",
"telephone_number": "323-266-1000",
"fax_number": "323-372-1662"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5060 S FORT APACHE RD",
"address_2": "#160",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891481731",
"telephone_number": "702-851-8200",
"fax_number": "702-851-8201"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GLOSMAN DENTAL GROUP, LTD",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "GLOSMAN DENTAL GROUP, LTD",
"enumeration_date": "2007-11-14",
"last_updated": "2013-06-07",
"status": "A",
"authorized_official_last_name": "GLOSMAN",
"authorized_official_first_name": "MONIQUE",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "CHIEF OF STAFF",
"authorized_official_telephone_number": "310-480-2307",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NV",
"license": "3580",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100512440",
"state": "NV"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Dentalville",
"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 Jun 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.