Providence Dental Dhillon PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

S6-81 Issued in NV

Legal business name

PROVIDENCE DENTAL DHILLON PLLC

Practice address

7181 N Hualapai Way
Suite 105
Las Vegas, NV 89166-1115

Phone

(702) 349-2420

NPI assigned

Jan 14, 2016

Organization subpart

No

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

Authorized official

Name

Tiffany Lorick

Title

Credentialing Specialist

Phone

(704) 806-3632

Specialties & licenses 1

Addresses

Other names 8

• Buffalo 215 Dental & Orthodontics Doing business as
• Canyon Family Dentistry Doing business as
• Edge Dental & Orthodontics Doing business as
• Hello Kids Dental Doing business as
• Inspirada Dental & Orthodontics Doing business as
• Red Rock Kids Dental Doing business as
• West Henderson Dental Doing business as
• Western Henderson Dental & Orthodontics Doing business as

Tax ID family

Providence Dental Dhillon PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Providence Dental Dhillon PLLC

  • General Practice Dentistry
  • Las Vegas, NV
  • NPI 1922533785
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Providence Dental Dhillon PLLC

  • General Practice Dentistry
  • Las Vegas, NV
  • NPI 1922533785
  NPPES parent name

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

{
    "created_epoch": "1452729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672704000000",
    "number": "1417313883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35145 LB 413169",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98124",
            "telephone_number": "919-948-6787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7181 N HUALAPAI WAY",
            "address_2": "SUITE 105",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891661115",
            "telephone_number": "702-349-2420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6530 S Buffalo Dr Ste 105",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891132169",
            "country_code": "US",
            "telephone_number": "702-505-9199",
            "fax_number": "702-505-4866",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9035 Blue Diamond Rd.",
            "address_2": "101",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "89178",
            "country_code": "US",
            "telephone_number": "702-997-0444",
            "fax_number": "702-997-6979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PROVIDENCE DENTAL DHILLON PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-14",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A",
        "authorized_official_last_name": "LORICK",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "704-806-3632"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NV",
            "license": "S6-81",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Buffalo 215 Dental & Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Canyon Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Edge Dental & Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hello Kids Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Inspirada Dental & Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Red Rock Kids Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "West Henderson Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "West Henderson Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Western Henderson Dental & Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Reginald Wayne Protho
• Proto Script Pharmacueticals Corp
• Leandra Madonna Kelly Proulx
• Provenance Healthcare LLC
• Jillian Provenza
• Providence Dental Dhillon PLLC
• Providence Healthcare of Nevada LLC
• Providence Hospice of Las Vegas LLC
• Providence Mental Health LLC
• Providence Orthodontics Dhillon PLLC

• Dentist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Dentist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2023; 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.