NPIMap

Organization Active NPI

Nevada Dental Professional, Quirt, Gates, PC

Doing business as Oak Grove Dental Care

  • Pediatric Dentistry
  • North Las Vegas, NV
National Provider Identifier
1235960055
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
NEVADA DENTAL PROFESSIONAL, QUIRT, GATES, PC
Doing business as
Oak Grove Dental Care
Practice address
1950 W Craig Rd
North Las Vegas, NV 89032-0316
Phone
(725) 316-5980
Fax
(725) 316-5981
NPI assigned
Aug 13, 2024
Last updated
Aug 13, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
NEVADA DENTAL PROFESSIONAL, QUIRT, GATES, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Authorized official

Name
Hillary Thull
Title
Credentialing Coordinator
Phone
(217) 540-8946

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X Primary

Addresses

Primary practice location

1950 W Craig Rd
North Las Vegas, NV 89032-0316

Mailing address

1950 W Craig Rd
North Las Vegas, NV 89032-0316

Other names 1

  • Oak Grove Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Nevada Dental Professional Quirt Gatespc23 organizations share this tax ID, including this one
Part of
Nevada Dental Professional Quirt Gatespc

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

Locations

1950 W Craig Rd
North Las Vegas, NV 89032
Phone (725) 316-5980

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1723507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723507200000",
    "number": "1235960055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 W CRAIG RD",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890320316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 W CRAIG RD",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890320316",
            "telephone_number": "725-316-5980",
            "fax_number": "725-316-5981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEVADA DENTAL PROFESSIONAL, QUIRT, GATES, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEVADA DENTAL PROFESSIONAL, QUIRT, GATES, PC",
        "enumeration_date": "2024-08-13",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A",
        "authorized_official_last_name": "THULL",
        "authorized_official_first_name": "HILLARY",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-8946"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oak Grove Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; 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.