Active NPI
William Joseph Maricondia, DDS
- General Practice Dentistry
- Henderson, NV
National Provider Identifier
1336179787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 4092
- Practice address
- 349 W Lake Mead Pkwy
Henderson, NV 89015-7029 - Phone
- (702) 565-6000
- Fax
- (702) 565-0474
- NPI assigned
- Jul 3, 2006
- Sex
- Male
- Sole proprietor
- No
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 | 4092 | NV | Primary |
Addresses
Primary practice location
349 W Lake Mead Pkwy
Henderson, NV 89015-7029
Mailing address
349 W Lake Mead Pkwy
Henderson, NV 89015-7029
Phone (702) 565-6000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140503000010 | NV | Practitioner - Oral Surgery | 8820221591 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maricondia Dental PC | General Practice | Current | Accepting new patients |
Locations
349 W Lake Mead Pkwy
Henderson, NV 89015
Phone (702) 565-6000
Organizations & group practices 1
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": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696464000000",
"number": "1336179787",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "349 W LAKE MEAD PKWY",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890157029",
"telephone_number": "702-565-6000",
"fax_number": "702-565-0474"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "349 W LAKE MEAD PKWY",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890157029",
"telephone_number": "702-565-6000",
"fax_number": "702-565-0474"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARICONDIA",
"first_name": "WILLIAM",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-03",
"last_updated": "2023-10-05",
"certification_date": "2023-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NV",
"license": "4092",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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 Oct 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.