Organization Active NPI

Rachel Mismas DDS LLC

  • Dental Clinic/Center
  • Las Vegas, NV
National Provider Identifier
1295334340
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
RACHEL MISMAS DDS LLC
Practice address
7035 W Ann Rd Ste 110
Las Vegas, NV 89130-3867
Phone
(702) 396-2929
Fax
(702) 658-6435
NPI assigned
Oct 20, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

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

Authorized official

Name
Rachel Anne Mismas, DDSNPI 1619015831
Title
Managing Member
Phone
(323) 334-6058

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

7035 W Ann Rd Ste 110
Las Vegas, NV 89130-3867

Mailing address

7035 W Ann Rd Ste 110
Las Vegas, NV 89130-3867
Phone (702) 396-2929

Other identifiers 1

IdentifierTypeStateIssuer
1619015831OtherCANPI

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.divinedentallv.com Direct

National Provider Directory

National Provider Directory

Locations

7035 W Ann Rd
Ste 110
Las Vegas, NV 89130
Phone (702) 396-2929

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1603152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603152000000",
    "number": "1295334340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7035 W ANN RD STE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891303867",
            "telephone_number": "702-396-2929",
            "fax_number": "702-658-6435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7035 W ANN RD STE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891303867",
            "telephone_number": "702-396-2929",
            "fax_number": "702-658-6435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RACHEL MISMAS DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-20",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A",
        "authorized_official_last_name": "MISMAS",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "323-334-6058",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1619015831",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.divinedentallv.com",
            "affiliation": "N",
            "endpointDescription": "website address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7035 W Ann Rd Ste 110",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891303867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Oct 20, 2020; 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.