Lone Mountain Family Dental

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

6547 Issued in NV

Legal business name

LONE MOUNTAIN FAMILY DENTAL

Practice address

4818 W Lone Mountain Rd
Las Vegas, NV 89130-2239

Phone

(702) 655-9533

Fax

(702) 655-9565

NPI assigned

Sep 16, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Joshua David Etman, DDS

Title

President/ Doctor

Phone

(702) 655-9533

Specialties & licenses 1

Addresses

Other names 1

• Lone Mountain Dental Former legal business name

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

{
    "created_epoch": "1442361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442361600000",
    "number": "1366811747",
    "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": "LONE MOUNTAIN FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-16",
        "last_updated": "2015-09-16",
        "status": "A",
        "authorized_official_last_name": "ETMAN",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT/ DOCTOR",
        "authorized_official_telephone_number": "702-655-9533",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "NV",
            "license": "6547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lone Mountain Dental",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Jessica Londakos
• Sabrina Londo
• London Family and Children's Services
• Yasmine London
• Lone Mountain Dental, LLC
• Lone Mountain Medical Centre (Goldsmith Healthcare, LTD)
• Unhoe Ku Lonero
• Puanani Elisha Lonetti
• Long Kevin Diep, Odpc
• Pearl Lee Long-Davis

• Preferred Provider Organization in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Preferred Provider Organization in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2015; 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.