MJD, LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

S2-112C Issued in NV

Legal business name

MJD, LLC

Practice address

4544 S Pecos Rd
Las Vegas, NV 89121-5923

Phone

(702) 436-0900

Fax

(702) 436-0636

NPI assigned

Mar 2, 2018

Organization subpart

Yes

Parent organization

MJD, LLCAs reported in NPPES

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

Authorized official

Name

Dr. Michel Joseph Daccache, DDSNPI 1285881243

Title

Owner

Phone

(702) 750-9444

Specialties & licenses 1

Addresses

Other names 1

• NevadaOMS Doing business as

Part of

MJD LLC

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.

• MJD, LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Las Vegas, NV
  • NPI 1558897884
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michel Daccache, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Las Vegas, NV
  • NPI 1285881243
  NPD Authorized official

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

{
    "created_epoch": "1519948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519948800000",
    "number": "1205338563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4544 S PECOS RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891215923",
            "telephone_number": "702-436-0900",
            "fax_number": "702-436-0636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4544 S PECOS RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891215923",
            "telephone_number": "702-436-0900",
            "fax_number": "702-436-0636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MJD, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MJD, LLC",
        "enumeration_date": "2018-03-02",
        "last_updated": "2018-03-02",
        "status": "A",
        "authorized_official_last_name": "DACCACHE",
        "authorized_official_first_name": "MICHEL",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-750-9444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NV",
            "license": "S2-112C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NevadaOMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Melissa Mizuhara
• Dillon Masakazu Mizukami, DC
• Leah Kiki Mizuno
• MJ LCSW LLC
• MJB View LLC
• MJD, LLC
• MJM Ventures LLC
• Mjmurray Services LLC
• MK Elevated LLC
• MK-Rdnutrition

• Oral and Maxillofacial Surgery (Dentist) in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Oral and Maxillofacial Surgery (Dentist) in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2018; 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.