Active NPI
Michael Louis Squitieri, D.D.S.
- Endodontics
- Las Vegas, NV
National Provider Identifier
1356520076
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- S7-14
- Practice address
- 3376 S Eastern Ave
Suite #130
Las Vegas, NV 89169-3380 - Phone
- (702) 734-1054
- Fax
- (702) 734-0191
- NPI assigned
- Oct 30, 2007
- 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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | S7-14 | NV | Primary |
Addresses
Primary practice location
3376 S Eastern Ave
Suite #130
Las Vegas, NV 89169-3380
Mailing address
3376 S Eastern Ave
Suite #130
Las Vegas, NV 89169-3380
Phone (702) 734-1054
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S7-14 | NV | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193702400000",
"number": "1356520076",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3376 S EASTERN AVE",
"address_2": "SUITE #130",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891693380",
"telephone_number": "702-734-1054",
"fax_number": "702-734-0191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3376 S EASTERN AVE",
"address_2": "SUITE #130",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891693380",
"telephone_number": "702-734-1054",
"fax_number": "702-734-0191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SQUITIERI",
"first_name": "MICHAEL",
"middle_name": "LOUIS",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-10-30",
"last_updated": "2007-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "NV",
"license": "S7-14",
"primary": true
}
],
"identifiers": [],
"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 Oct 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.