Henderson Pediatric Dentistry PC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

HENDERSON PEDIATRIC DENTISTRY PC

Practice address

390 N Stephanie St Ste 104
Henderson, NV 89014-8029

Phone

(720) 603-4700

NPI assigned

May 8, 2018

Last updated

May 8, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Diane Stacey

Title

Dr

Phone

(303) 603-4800

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1525737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525737600000",
    "number": "1326537028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 N STEPHANIE ST STE 104",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890148029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 N STEPHANIE ST STE 104",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890148029",
            "telephone_number": "720-603-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENDERSON PEDIATRIC DENTISTRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-08",
        "last_updated": "2018-05-08",
        "status": "A",
        "authorized_official_last_name": "STACEY",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "DR",
        "authorized_official_telephone_number": "303-603-4800"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Henderson Long Term Care LLC (Green Valley Health and Wellness Suites)
• Henderson Modern Dentistry
• Henderson OB/GYN LLC
• Henderson Operating Company LLC (Lake Mead Health & Rehabilitation Center)
• Henderson Pediatric Dentistry Hon DMD PC (Cosmic Kids Dental)
• Henderson Pediatrics PLLC
• Henderson Pediatrics, LLP
• Henderson Pharmacy LLC (Henderson Pharmacy)
• Henderson Primary, Professional LLC
• Henderson Psychiatry Corporation

• Pediatric Dentistry in Henderson, NV
• Providers in Henderson, NV by specialty
• Pediatric Dentistry in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2018; 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.