NPIMap

Organization Active NPI

Ivy Dental Inc.

  • General Practice Dentistry
  • Las Vegas, NV
National Provider Identifier
1417980665
Registry record updated Jan 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3468 Issued in NV
Legal business name
IVY DENTAL INC.
Practice address
740 N Eastern Ave
#120
Las Vegas, NV 89101-2850
Phone
(702) 678-6218
Fax
(702) 678-5102
NPI assigned
Jul 9, 2006
Last updated
Jan 24, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2008

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

Authorized official

Name
Dr. Richard Y.Y. Wu, D.D.S.
Title
Doctor/President
Phone
(702) 678-6218

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 3468 NV Primary

Addresses

Primary practice location

740 N Eastern Ave
#120
Las Vegas, NV 89101-2850

Mailing address

740 N Eastern Ave
#120
Las Vegas, NV 89101-2850
Phone (702) 678-6218

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201132800000",
    "number": "1417980665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 N EASTERN AVE",
            "address_2": "#120",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891012850",
            "telephone_number": "702-678-6218",
            "fax_number": "702-678-5102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 N EASTERN AVE",
            "address_2": "#120",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891012850",
            "telephone_number": "702-678-6218",
            "fax_number": "702-678-5102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVY DENTAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2008-01-24",
        "status": "A",
        "authorized_official_last_name": "WU",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "Y.Y.",
        "authorized_official_title_or_position": "DOCTOR/PRESIDENT",
        "authorized_official_telephone_number": "702-678-6218",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "3468",
            "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 Jan 24, 2008; 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.