NPIMap

Organization Active NPI

Nevada Dental Professional, Quirt, Kruyer, P.C.

  • General Practice Dentistry
  • Henderson, NV
National Provider Identifier
1306192273
Registry record updated Sep 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
NEVADA DENTAL PROFESSIONAL, QUIRT, KRUYER, P.C.
Practice address
10410 S Eastern Ave Ste 200
Henderson, NV 89052-4141
Phone
(702) 616-0777
NPI assigned
Jul 30, 2012
Organization subpart
Yes
Parent organization
NEVADA DENTAL PROFESSIONAL, QUIRT, KRUYER, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 26, 2022

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

Authorized official

Name
Carmen Woods
Title
Credentialing Manager
Phone
(217) 540-5141

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

10410 S Eastern Ave Ste 200
Henderson, NV 89052-4141

Mailing address

10410 S Eastern Ave Ste 200
Henderson, NV 89052-4141
Phone (702) 616-0777

Other names 1

  • Center for Cosmetic & Family Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Nevada Dental Professional Quirt Gatespc22 organizations share this tax ID, including this one
Part of
Nevada Dental Professional Quirt Gatespc

Other organizations with this tax ID 21

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

View all 21

Locations

10410 S Eastern Ave
Ste 200
Henderson, NV 89052
Phone (702) 616-0777

Practitioners & affiliated clinicians

Practitioners 1

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": "1343606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664150400000",
    "number": "1306192273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10410 S EASTERN AVE STE 200",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890524141",
            "telephone_number": "702-616-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10410 S EASTERN AVE STE 200",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890524141",
            "telephone_number": "702-616-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEVADA DENTAL PROFESSIONAL, QUIRT, KRUYER, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEVADA DENTAL PROFESSIONAL, QUIRT, KRUYER, P.C.",
        "enumeration_date": "2012-07-30",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A",
        "authorized_official_last_name": "WOODS",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "217-540-5141"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center for Cosmetic & Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Center for Cosmetic & Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2022; 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.