NPIMap

Organization Active NPI

Heavenly Smiles Mobile Dental

  • Dental Hygienist
  • Las Vegas, NV
National Provider Identifier
1336755362
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
Legal business name
HEAVENLY SMILES MOBILE DENTAL
Practice address
6337 Hawthorn Woods Ave
Las Vegas, NV 89130-1389
Phone
(702) 445-1060
NPI assigned
Sep 16, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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

Authorized official

Name
Mrs. Janet CrosswhiteNPI 1205458262
Title
Manager
Phone
(313) 806-4786

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 HygienistGroup: 193400000X SINGLE SPECIALTY GROUP 124Q00000X Primary

Addresses

Primary practice location

6337 Hawthorn Woods Ave
Las Vegas, NV 89130-1389

Mailing address

6337 Hawthorn Woods Ave
Las Vegas, NV 89130-1389
Phone (702) 445-1060

Other identifiers 1

IdentifierTypeStateIssuer
250008207MedicaidNV

National Provider Directory

National Provider Directory

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": "1600214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600214400000",
    "number": "1336755362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6337 HAWTHORN WOODS AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891301389",
            "telephone_number": "702-445-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6337 HAWTHORN WOODS AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891301389",
            "telephone_number": "702-445-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAVENLY SMILES MOBILE DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-16",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A",
        "authorized_official_last_name": "CROSSWHITE",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "313-806-4786",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dental Hygienist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "250008207",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "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 Sep 16, 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.