NPIMap

Organization Active NPI

Radiant Smiles

  • General Practice Dentistry
  • Las Vegas, NV
National Provider Identifier
1417408477
Registry record updated Oct 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6837 Issued in NV
Legal business name
RADIANT SMILES
Practice address
1825 S Nellis Blvd
Las Vegas, NV 89104-6215
Phone
(702) 432-0199
NPI assigned
Oct 14, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2016

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

Authorized official

Name
Adrian Ruiz, DDS
Title
Owner Dentist
Phone
(702) 432-0199

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 6837 NV Primary

Addresses

Primary practice location

1825 S Nellis Blvd
Las Vegas, NV 89104-6215

Mailing address

1825 S Nellis Blvd
Las Vegas, NV 89104-6215
Phone (702) 432-0199

National Provider Directory

National Provider Directory
Tax ID family
Radiant Smiles2 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.

Locations

1825 S Nellis Blvd
Las Vegas, NV 89104
Phone (702) 432-0199

NPI Registry JSON

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

{
    "created_epoch": "1476403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476403200000",
    "number": "1417408477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 S NELLIS BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891046215",
            "telephone_number": "702-432-0199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 S NELLIS BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891046215",
            "telephone_number": "702-432-0199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIANT SMILES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-14",
        "last_updated": "2016-10-14",
        "status": "A",
        "authorized_official_last_name": "RUIZ",
        "authorized_official_first_name": "ADRIAN",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "702-432-0199",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "6837",
            "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 Oct 14, 2016; 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.