Individual provider Active NPI

Paymon Paul Mehryar

  • Periodontics
  • Las Vegas, NV
National Provider Identifier
1245708551
Registry record updated Aug 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
S4-115C Issued in NV
Practice address
45 E Silverado Ranch Blvd Ste 100
Las Vegas, NV 89183-3480
Phone
(702) 425-6810
NPI assigned
Nov 5, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X S4-115C NV Primary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 34644 TX

Addresses

Primary practice location

45 E Silverado Ranch Blvd Ste 100
Las Vegas, NV 89183-3480

Mailing address

45 E Silverado Ranch Blvd Ste 100
Las Vegas, NV 89183-3480
Phone (702) 425-6810

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
34644TXMDGeneral Practice Dentistry
S4-115CNVMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Zaragoza Dental Care PLLC Past Accepting new patients
Karimzada Silverado Ranch Dentistry, PC PastSince Aug 8, 2021 Accepting new patients
Oral Healthcare Consulting and Education PLLC General Practice PastSince Jan 4, 2026 Accepting new patients

Organizations & group practices 3

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": "1541376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1245708551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 E SILVERADO RANCH BLVD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891833480",
            "telephone_number": "702-425-6810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 E SILVERADO RANCH BLVD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891833480",
            "telephone_number": "702-425-6810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHRYAR",
        "first_name": "PAYMON",
        "middle_name": "PAUL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-05",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NV",
            "license": "S4-115C",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "34644",
            "primary": false
        }
    ],
    "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 Aug 4, 2021; 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.