NPIMap

Organization Active NPI

Radiant Dental 1

  • Preferred Provider Organization
  • Las Vegas, NV
National Provider Identifier
1225218951
Registry record updated Nov 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
License
4480 Issued in NV
Legal business name
RADIANT DENTAL 1
Practice address
7469 W Lake Mead Blvd
Suite 270
Las Vegas, NV 89128-1030
Phone
(702) 312-8710
NPI assigned
Nov 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2007

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

Authorized official

Name
David C Gonzalez
Title
Owner
Phone
(702) 610-5458

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preferred Provider Organization 305R00000X 4480 NV Primary

Addresses

Primary practice location

7469 W Lake Mead Blvd
Suite 270
Las Vegas, NV 89128-1030

Mailing address

7469 W Lake Mead Blvd
Suite 270
Las Vegas, NV 89128-1030
Phone (702) 312-8710

National Provider Directory

National Provider Directory

Locations

7469 W Lake Mead Blvd
Ste 270
Las Vegas, NV 89128
Phone (702) 312-8710

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": "1194566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194566400000",
    "number": "1225218951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7469 W LAKE MEAD BLVD",
            "address_2": "SUITE 270",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891281030",
            "telephone_number": "702-312-8710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7469 W LAKE MEAD BLVD",
            "address_2": "SUITE 270",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891281030",
            "telephone_number": "702-312-8710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIANT DENTAL 1",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-09",
        "last_updated": "2007-11-09",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-610-5458"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "NV",
            "license": "4480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Nov 9, 2007; 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.