Individual provider Active NPI

Luiz Alfredo Dos Santos, DMD

  • General Practice Dentistry
  • Las Vegas, NV
National Provider Identifier
1235250796
Registry record updated Nov 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5058 Issued in NV
Practice address
1350 S Jones Blvd Ste 140
Las Vegas, NV 89146-1206
Phone
(702) 870-6161
Fax
(702) 648-7343
NPI assigned
Apr 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5058 NV Primary

Addresses

Primary practice location

1350 S Jones Blvd Ste 140
Las Vegas, NV 89146-1206

Mailing address

1350 S Jones Blvd Ste 140
Las Vegas, NV 89146-1233
Phone (702) 870-6161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151201000692 NV Order and Referring Only - DentistPractitioner - Dentist 6608176490

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5058NVMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Luiz Dos Santos Inc Past Accepting new patients

Organizations & group practices 1

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": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541721600000",
    "number": "1235250796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 S JONES BLVD STE 140",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891461233",
            "telephone_number": "702-870-6161",
            "fax_number": "702-870-2302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 S JONES BLVD STE 140",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891461206",
            "telephone_number": "702-870-6161",
            "fax_number": "702-648-7343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOS SANTOS",
        "first_name": "LUIZ",
        "middle_name": "ALFREDO",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2018-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "5058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.