NPIMap

Organization Active NPI

Steven Delisle DDS PC

Doing business as sedation dental center of las vegas

  • General Practice Dentistry
  • North Las Vegas, NV
National Provider Identifier
1215353511
Registry record updated Mar 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5929 Issued in NV
Legal business name
STEVEN DELISLE DDS PC
Doing business as
sedation dental center of las vegas
Practice address
4090 N Martin L King Blvd
North Las Vegas, NV 89032-3218
Phone
(702) 489-5460
NPI assigned
Mar 11, 2014
Last updated
Mar 11, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2014

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

Authorized official

Name
Steven Delisle, DDS
Title
Owner
Phone
(702) 489-5460

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5929 NV Primary

Addresses

Primary practice location

4090 N Martin L King Blvd
North Las Vegas, NV 89032-3218

Mailing address

4090 N Martin L King Blvd
North Las Vegas, NV 89032-3218
Phone (702) 489-5460

Other identifiers 1

IdentifierTypeStateIssuer
22MedicaidNV

Other names 1

  • sedation dental center of las vegas Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Steven Delisle DDS PC16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

Locations

4090 N Martin L King Blvd
North Las Vegas, NV 89032
Phone (702) 489-5460

Practitioners & affiliated clinicians

Practitioners 1

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": "1394496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394496000000",
    "number": "1215353511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4090 N MARTIN L KING BLVD",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890323218",
            "telephone_number": "702-489-5460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4090 N MARTIN L KING BLVD",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890323218",
            "telephone_number": "702-489-5460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVEN DELISLE DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-11",
        "last_updated": "2014-03-11",
        "status": "A",
        "authorized_official_last_name": "DELISLE",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-489-5460",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "5929",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "22",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "sedation dental center of las vegas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2014; 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.