Individual provider Active NPI

Ingrid Segui, DMD

  • Dentist
  • Las Vegas, NV
National Provider Identifier
1184303810
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7860 Issued in NV
Practice address
10040 Alta Dr Ste 100
Las Vegas, NV 89145-8630
Phone
(702) 425-3060
NPI assigned
Jul 11, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 7860 NV Primary

Addresses

Primary practice location

10040 Alta Dr Ste 100
Las Vegas, NV 89145-8630

Mailing address

8233 Cactus Canyon CT
Las Vegas, NV 89128-8237
Phone (786) 366-2785

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
I20231017003417 NV Order and Referring Only - DentistPractitioner - Dentist 2961857552

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7860NVMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Luckoor Queensridge Modern Dentistry, PC CurrentSince Jul 16, 2023 Accepting new patients

Locations

10040 Alta Dr
Ste 100
Las Vegas, NV 89145
Phone (702) 425-3060

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1689033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1184303810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8233 CACTUS CANYON CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891288237",
            "telephone_number": "786-366-2785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10040 ALTA DR STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891458630",
            "telephone_number": "702-425-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEGUI",
        "first_name": "INGRID",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-11",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NV",
            "license": "7860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.