Active NPI
Richard Anthony Racanelli, DMD
- General Practice Dentistry
- Las Vegas, NV
National Provider Identifier
1265582282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 6264
- Practice address
- 6410 Medical Center St Ste B
Las Vegas, NV 89148-2401 - Phone
- (702) 736-0016
- Fax
- (702) 736-0057
- NPI assigned
- Jan 11, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 6264 | NV | Primary |
Addresses
Primary practice location
6410 Medical Center St Ste B
Las Vegas, NV 89148-2401
Mailing address
6410 Medical Center St Ste B
Las Vegas, NV 89148-2401
Phone (702) 736-0016
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6264 | NV | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1387238400000",
"number": "1265582282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6410 MEDICAL CENTER ST STE B",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891482401",
"telephone_number": "702-736-0016",
"fax_number": "702-736-0057"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6410 MEDICAL CENTER ST STE B",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891482401",
"telephone_number": "702-736-0016",
"fax_number": "702-736-0057"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RACANELLI",
"first_name": "RICHARD",
"middle_name": "ANTHONY",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-11",
"last_updated": "2013-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NV",
"license": "6264",
"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 Dec 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.