Individual provider Active NPI

Jennifer Brown, DMD

  • Dentist
  • Las Vegas, NV
National Provider Identifier
1225514367
Registry record updated Jul 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7105 Issued in NV
Practice address
10870 W Charleston Blvd Ste 170
Las Vegas, NV 89135-1170
Phone
(702) 254-6412
NPI assigned
Jul 12, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 7105 NV Primary

Addresses

Primary practice location

10870 W Charleston Blvd Ste 170
Las Vegas, NV 89135-1170

Mailing address

9072 Heavenly Valley Ave
Las Vegas, NV 89147-7828
Phone (702) 217-6469

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7105NVMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Shahrestani Canyon Pointe Dental Group PC Past Accepting new patients
Khakwani Medical Corporation, PC Past Accepting new patients

Organizations & group practices 2

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": "1531353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531353600000",
    "number": "1225514367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9072 HEAVENLY VALLEY AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891477828",
            "telephone_number": "702-217-6469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10870 W CHARLESTON BLVD STE 170",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891351170",
            "telephone_number": "702-254-6412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JENNIFER",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-12",
        "last_updated": "2018-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NV",
            "license": "7105",
            "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 Jul 12, 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.