Active NPI
Tom Godfrey DMD PLLC
- Dental Clinic/Center
- Las Vegas, NV
National Provider Identifier
1336800697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Clinic/Center
- Legal business name
- TOM GODFREY DMD PLLC
- Practice address
- 4818 W Lone Mountain Rd
Las Vegas, NV 89130-2239 - Phone
- (702) 655-9533
- Fax
- (702) 655-9565
- NPI assigned
- Jan 7, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Thomas Godfrey, DMD
- Title
- Doctor
- Phone
- (702) 655-9533
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Clinic/Center | 261QD0000X | Primary |
Addresses
Primary practice location
4818 W Lone Mountain Rd
Las Vegas, NV 89130-2239
Mailing address
4818 W Lone Mountain Rd
Las Vegas, NV 89130-2239
Phone (702) 655-9533
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6936 | Other | NV | 1063844710 |
Other names 1
- Lone Mountain Dental
National Provider Directory
National Provider Directory- Tax ID family
- Lone Mountain Dental
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- General Practice Dentistry
- Las Vegas, NV
- NPI 1982568432
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- General Practice Dentistry
- Las Vegas, NV
- NPI 1063844710
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1641513600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1641513600000",
"number": "1336800697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4818 W LONE MOUNTAIN RD",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891302239",
"telephone_number": "702-655-9533",
"fax_number": "702-655-9565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4818 W LONE MOUNTAIN RD",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891302239",
"telephone_number": "702-655-9533",
"fax_number": "702-655-9565"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TOM GODFREY DMD PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-01-07",
"last_updated": "2022-01-07",
"certification_date": "2022-01-07",
"status": "A",
"authorized_official_last_name": "GODFREY",
"authorized_official_first_name": "THOMAS",
"authorized_official_title_or_position": "DOCTOR",
"authorized_official_telephone_number": "702-655-9533",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DMD"
},
"taxonomies": [
{
"code": "261QD0000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Dental",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "1063844710",
"identifier": "6936",
"state": "NV"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Lone Mountain Dental",
"code": "3",
"type": "Doing Business As"
}
]
}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 Jan 7, 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.