NPIMap

Organization Active NPI

Gussow Dental Care Prof Corp

Doing business as Vegas Smiles

  • General Practice Dentistry
  • Las Vegas, NV
National Provider Identifier
1174398416
Registry record updated Feb 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
GUSSOW DENTAL CARE PROF CORP
Doing business as
Vegas Smiles
Practice address
4343 N Rancho Dr Ste 131
Las Vegas, NV 89130-3422
Phone
(702) 395-7200
NPI assigned
Nov 16, 2023
Last updated
Feb 14, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2025

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

Authorized official

Name
Jonathan Welch, DMDNPI 1174885180
Title
Managing Member
Phone
(702) 371-0221

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X NU
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

4343 N Rancho Dr Ste 131
Las Vegas, NV 89130-3422

Mailing address

10420 S Decatur Blvd Ste 110
Las Vegas, NV 89141-8718
Phone (702) 371-0221

Other names 1

  • Vegas Smiles Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1700092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739491200000",
    "number": "1174398416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10420 S DECATUR BLVD STE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891418718",
            "telephone_number": "702-371-0221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 N RANCHO DR STE 131",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891303422",
            "telephone_number": "702-395-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUSSOW DENTAL CARE PROF CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-16",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A",
        "authorized_official_last_name": "WELCH",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "702-371-0221",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vegas Smiles",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vegas Smiles",
            "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 Feb 14, 2025; 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.