NPIMap

Organization Active NPI

Miles of Smiles Ventures, LLC

  • Dentist
  • Las Vegas, NV
National Provider Identifier
1235329210
Registry record updated Mar 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4522T Issued in NV
Legal business name
MILES OF SMILES VENTURES, LLC
Practice address
4040 N. Martin Luther King
Ste B.
Las Vegas, NV 89032-3205
Phone
(702) 639-3515
Fax
(702) 639-3516
NPI assigned
Jul 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2012

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

Authorized official

Name
Sherill Banks
Title
Office Manager
Phone
(702) 639-3515

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 4522T NV Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 4522T NV

Addresses

Primary practice location

4040 N. Martin Luther King
Ste B.
Las Vegas, NV 89032-3205

Mailing address

4040 N. Martin Luther King
Ste B.
Las Vegas, NV 89032-3205
Phone (702) 639-3515

Other identifiers 2

IdentifierTypeStateIssuer
100506669MedicaidNV
100502976MedicaidNV

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330646400000",
    "number": "1235329210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 N. MARTIN LUTHER KING",
            "address_2": "STE B.",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "890323205",
            "telephone_number": "702-639-3515",
            "fax_number": "702-639-3516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 N. MARTIN LUTHER KING",
            "address_2": "STE B.",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "890323205",
            "telephone_number": "702-639-3515",
            "fax_number": "702-639-3516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILES OF SMILES VENTURES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-26",
        "last_updated": "2012-03-02",
        "status": "A",
        "authorized_official_last_name": "BANKS",
        "authorized_official_first_name": "SHERILL",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "702-639-3515"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NV",
            "license": "4522T",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "4522T",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100506669",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100502976",
            "state": "NV"
        }
    ],
    "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 Mar 2, 2012; 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.