NPIMap

Organization Active NPI

Tender Dental Boulder, LLC

  • General Practice Dentistry
  • Las Vegas, NV
National Provider Identifier
1215467295
Registry record updated Feb 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
TENDER DENTAL BOULDER, LLC
Doing business as
Silver Stream Dental
Practice address
5230 Boulder Hwy Ste 130
Las Vegas, NV 89122-6079
Phone
(702) 851-6724
NPI assigned
Jun 13, 2017
Organization subpart
Yes
Parent organization
TENDER DENTAL MANAGEMENT, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 4, 2022

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

Authorized official

Name
Dr. Michael Lawrence ShermanNPI 1245323559
Title
Clinical Director
Phone
(631) 806-1275

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

5230 Boulder Hwy Ste 130
Las Vegas, NV 89122-6079

Mailing address

5230 Boulder Hwy Ste 130
Las Vegas, NV 89122-6079
Phone (702) 851-6724

Other names 1

  • Silver Stream Dental Doing business as

National Provider Directory

National Provider Directory
Part of
Tender Dental Management LLC

Ownership & related parties

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.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1497312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643932800000",
    "number": "1215467295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5230 BOULDER HWY STE 130",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891226079",
            "telephone_number": "702-851-6724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5230 BOULDER HWY STE 130",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891226079",
            "telephone_number": "702-851-6724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENDER DENTAL BOULDER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TENDER DENTAL MANAGEMENT, LLC",
        "enumeration_date": "2017-06-13",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A",
        "authorized_official_last_name": "SHERMAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "LAWRENCE",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "631-806-1275",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Silver Stream Dental",
            "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 4, 2022; 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.