Individual provider Active NPI

Steven DO, D.D.S.

  • Dentist
  • Las Vegas, NV
National Provider Identifier
1366813362
Registry record updated Sep 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6732 Issued in NV
Practice address
893 S. Raindbow Blvd
Las Vegas, NV 89145
Phone
(702) 456-0034
Fax
(702) 856-0035
NPI assigned
Oct 15, 2015
Last updated
Sep 10, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 65194 CA
Dentist 122300000X 6988 OK
Dentist 122300000X 6732 NV Primary

Addresses

Primary practice location

893 S. Raindbow Blvd
Las Vegas, NV 89145

Mailing address

893 S. Raindbow Blvd
Las Vegas, NV 89145
Phone (702) 456-0034

Other practice location 1

701 W Valley Blvd Ste 25
Alhambra, CA 91803-3242
Phone (626) 380-7616

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

LicenseStateTypeSpecialty
65194CAMDClinical Social Worker
6988OKMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Steven DO DDS, PLLC Current Accepting new patients
Brown Dental Office PC PastSince Jun 1, 2020 Accepting new patients

Locations

893 S Rainbow Blvd
Las Vegas, NV 89145
Phone (702) 456-0034

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1444867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1366813362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "893 S. RAINDBOW BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89145",
            "telephone_number": "702-456-0034",
            "fax_number": "702-856-0035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "893 S. RAINDBOW BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89145",
            "telephone_number": "702-456-0034",
            "fax_number": "702-856-0035"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 W Valley Blvd Ste 25",
            "address_purpose": "LOCATION",
            "city": "Alhambra",
            "state": "CA",
            "postal_code": "918033242",
            "country_code": "US",
            "telephone_number": "626-380-7616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DO",
        "first_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-15",
        "last_updated": "2021-09-10",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "65194",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "6988",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NV",
            "license": "6732",
            "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 Sep 10, 2021; 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.