Individual provider Active NPI

Jennifer Clement, D.M.D

  • General Practice Dentistry
  • Las Vegas, NV
National Provider Identifier
1174999486
Registry record updated Aug 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6677 Issued in NV
Practice address
7171 W Craig Rd
Ste 102
Las Vegas, NV 89129-6018
Phone
(702) 655-0331
Fax
(702) 655-0377
NPI assigned
Aug 20, 2015
Last updated
Aug 20, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6677 NV Primary

Addresses

Primary practice location

7171 W Craig Rd
Ste 102
Las Vegas, NV 89129-6018

Mailing address

7171 W Craig Rd
Ste 102
Las Vegas, NV 89129-6018
Phone (702) 655-0331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161005002741 NV Order and Referring Only - DentistPractitioner - Dentist 8527356674

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6677NVMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Shahrestani Las Vegas Modern Dentistry, PC General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1440028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440028800000",
    "number": "1174999486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7171 W CRAIG RD",
            "address_2": "STE 102",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891296018",
            "telephone_number": "702-655-0331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7171 W CRAIG RD",
            "address_2": "STE 102",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891296018",
            "telephone_number": "702-655-0331",
            "fax_number": "702-655-0377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENT",
        "first_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-20",
        "last_updated": "2015-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "6677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.