Jonathan Minsoo Skelton, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7103 Issued in NV

Practice address

1820 E Craig Rd Ste 102
North Las Vegas, NV 89030-3321

Phone

(702) 680-1009

NPI assigned

Aug 21, 2018

Last updated

Aug 21, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lee Craig Ranch Dental Group, PC

  • Dentist
  • Las Vegas, NV
  • NPI 1649793324
  NPD (past)

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

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534809600000",
    "number": "1336629039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 E CRAIG RD STE 102",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890303321",
            "telephone_number": "702-680-1009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 E CRAIG RD STE 102",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890303321",
            "telephone_number": "702-680-1009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKELTON",
        "first_name": "JONATHAN",
        "middle_name": "MINSOO",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-21",
        "last_updated": "2018-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "7103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kameron Allen Sitgraves
• Susil Sivaraman, M.D.
• Janea Sizemore
• Kattie Skaggs
• Takeya Skannal
• Skills 4 Kids
• Skills on Wheels, LLC
• Brenda Slack
• Raychel Slack
• Thomas Christopher Slawinski, LCSW

• General Practice Dentistry in North Las Vegas, NV
• Providers in North Las Vegas, NV by specialty
• General Practice Dentistry in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2018; 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.

Verify at the official NPI Registry.