Abdelaziz De Vol

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7565 Issued in NV

Practice address

4301 E Sunset Rd Ste 100
Henderson, NV 89014-2238

Phone

(702) 465-8187

NPI assigned

Aug 31, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Mugleston Green Valley Modern Dentistry, PC

  • General Practice Dentistry
  • Henderson, NV
  • NPI 1740650118
  NPD (past)

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

{
    "created_epoch": "1630368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1407524820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2338 N GREEN VALLEY PKWY APT 728",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890143698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 E SUNSET RD STE 100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890142238",
            "telephone_number": "702-465-8187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE VOL",
        "first_name": "ABDELAZIZ",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-31",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "7565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reese De la Villefromoy, LCSW
• Agnes Galaites De Leon
• Keesha Leigh De Leon
• Lorna De Leon
• Terrylyne Dasilag De Mateo
• Shana Mercedes Deadmon
• Dean a Sousa OD PC
• Ieisha R Dean
• Kristina Dean
• Tyesha Dean

• General Practice Dentistry in Henderson, NV
• Providers in Henderson, NV by specialty
• General Practice Dentistry in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.