Individual provider Active NPI

Sheronda Michelle Strider-Barraza, DMD

  • General Practice Dentistry
  • North Las Vegas, NV
National Provider Identifier
1366969164
Registry record updated Aug 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6910 Issued in NV
Practice address
640 E Deer Springs Way Ste 180
North Las Vegas, NV 89086-1514
Phone
(702) 399-3800
Fax
(702) 399-3801
NPI assigned
Aug 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6910 NV Primary

Addresses

Primary practice location

640 E Deer Springs Way Ste 180
North Las Vegas, NV 89086-1514

Mailing address

640 E Deer Springs Way Ste 180
North Las Vegas, NV 89086-1514
Phone (702) 399-3800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171228000796 NV Order and Referring Only - DentistPractitioner - Dentist 9830457621

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Shahrestani Deer Springs Modern Dentistry, PC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1503446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503446400000",
    "number": "1366969164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 E DEER SPRINGS WAY STE 180",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890861514",
            "telephone_number": "702-399-3800",
            "fax_number": "702-399-3801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 E DEER SPRINGS WAY STE 180",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890861514",
            "telephone_number": "702-399-3800",
            "fax_number": "702-399-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRIDER-BARRAZA",
        "first_name": "SHERONDA",
        "middle_name": "MICHELLE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-23",
        "last_updated": "2017-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "6910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.